Senior Director, Total Rewards
National University
Senior Director, Behavioral Health Utilization Management
Centene Corporation
full-time
Posted on:
Location Type: Remote
Location: Remote • Florida • 🇺🇸 United States
Visit company websiteSalary
💰 $157,600 - $290,800 per year
Job Level
Senior
About the role
- Leads and directs the behavioral health (BH) utilization management team to ensure appropriate member care
- Ensures consistency of policies, procedures, and processes
- Works with BH senior leadership on utilization management issues related to member care, provider interactions, and facilitates operations
- Provides oversight and leadership to the development, implementation, monitoring, and ongoing improvement of the BH utilization management process
- Provides BH senior leadership team a vision and direction for the department to help achieve functional goals
- Develops and implements BH utilization management methods, policies, and procedures to achieve cost-effective healthcare results
- Engages with onboarding, hiring, and training new BH utilization management team members
- Attends and presents at Health Plan and senior level leadership meetings
Requirements
- Requires Graduate of an Accredited School of Nursing or Bachelor's degree
- 10+ years of related experience, including prior management experience
- 5+ years management experience preferred
- License to practice independently
- Expert knowledge of BH industry regulations, policies, and standards preferred
- Advanced understanding of medical necessity criteria for a broad range of BH services preferred
Benefits
- competitive pay
- health insurance
- 401K and stock purchase plans
- tuition reimbursement
- paid time off plus holidays
- flexible approach to work with remote, hybrid, field or office work schedules
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard skills
utilization managementhealthcare policiesBH servicesmedical necessity criteria
Soft skills
leadershipteam managementcommunicationpresentation skills
Certifications
Licensed Nurse
