Senior Manager, Behavioral Health Utilization Management

Centene Corporation

Senior Manager overseeing Centene’s behavioral health utilization management clinicians. Driving compliant, cost-effective member care, team performance, and clinical operations.

Posted 9/4/2026full-timeRemote • Florida • 🇺🇸 United StatesSenior💰 $102,900 - $190,500 per yearWebsite

Core Competencies

Role fit

Core Competencies

Use this summary to align your resume positioning with the role.

Demonstrates expertise in managing behavioral health utilization review processes, ensuring compliance with regulations and guidelines, and leading cross-functional teams to achieve performance goals. Proficient in developing policies and providing training to enhance team effectiveness and operational efficiency.

Highest-signal resume keywords

Active Clinical LicenseUtilization Management PrinciplesManagement ExperienceMedical Necessity CriteriaCross-Functional Leadership

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Utilization ReviewData AnalysisPolicy DevelopmentFinancial ReportingPerformance TrackingProcess ImprovementTraining and OnboardingBehavioral Health ServicesCompliance StandardsOperational Management

Soft Skills

LeadershipCommunicationProblem-SolvingTeam DevelopmentTime Management

Certifications & Qualifications

LCSWLMHCLPCLMFTLMHPRN

Industry Keywords

Behavioral HealthUtilization ManagementAccreditation StandardsClinical GuidelinesContractual Compliance

About the role

Key responsibilities & impact

Manage behavioral health utilization review clinicians to ensure appropriate member care
Oversee compliance with applicable guidelines, regulations, contractual and accreditation standards, and industry best practices
Review and analyze utilization management activities, utilization levels, operations, costs, and forecasted data
Track goals, objectives, and HBR performance for the behavioral health utilization management team
Manage and review utilization management and financial reports, identify trends, and recommend improvements to senior leadership
Identify and present process improvements to the behavioral health senior leadership team
Develop and implement utilization management policies, procedures, and guidelines
Educate and provide resources to the utilization management team
Oversee training and support onboarding, hiring, and training strategies for team members
Provide career development feedback to Supervisors and lead talent management activities
Attend company meetings in the people leader's absence
Manage escalated calls and issues requiring additional research or special handling
Lead change and manage cross-functional work within tight deadlines
Perform other duties as assigned and comply with all policies and standards

Requirements

What you’ll need

Active clinical license: LCSW, LMHC, LPC, LMFT, LMHP, or RN
Graduate of an Accredited School of Nursing or Bachelor's degree
6+ years of related experience, including prior management experience
3+ years management experience preferred
License to practice independently and/or state-required licensure
Strong knowledge of utilization management principles preferred
Advanced understanding of medical necessity criteria for a broad range of BH services preferred
Ability to lead and manage others in a matrixed/cross-functional environment with tight timeframes and strict deadlines
Ability to present information and respond to questions from peers, leaders, and internal/external customers

Benefits

Comp & perks

Competitive pay
Health insurance
401K
Stock purchase plans
Tuition reimbursement
Paid time off plus holidays
Flexible approach to work with remote, hybrid, field or office work schedules
Additional forms of incentives may be included in total compensation
Equal opportunity employer committed to diversity