Davita Inc.
Sr. Manager, Behavioral Health Utilization Management
Davita Inc., Lodi, California, United States, 95240
Your Role
The Behavioral Health Utilization Management (UM) team performs prior authorization and concurrent reviews by applying evidenced-based guidelines, policies, and nationally recognized clinical criteria across multiple lines of business. The Sr. Manager, Program Management Clinical, will report to the Director, Behavioral Health Utilization Management. In this role, you will be responsible for managing all aspects of day-to-day operations of the Behavioral Health UM program, including adherence to regulatory compliance and direct oversight of performance quality. Our leadership model focuses on developing great leaders at all levels and creating opportunities for our people to grow—personally, professionally, and financially. We seek leaders energized by creative and critical thinking, building and sustaining high-performing teams, achieving results ethically, and fostering continuous learning.
Your Knowledge and Experience
Current unrestricted CA license (LCSW, LMFT, LPCC, PhD/PsyD, or RN with Behavioral Health experience) required; requires a bachelor's degree
At least ten (10) years of relevant experience
Four (4) years of management experience, including supervision of clinical staff
Three (3) years conducting Utilization Management for a health plan
Strong understanding of behavioral health utilization management, including application of multiple standardized clinical criteria sets such as MCG guidelines, nonprofit association guidelines, and various Medicare guidelines
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The Behavioral Health Utilization Management (UM) team performs prior authorization and concurrent reviews by applying evidenced-based guidelines, policies, and nationally recognized clinical criteria across multiple lines of business. The Sr. Manager, Program Management Clinical, will report to the Director, Behavioral Health Utilization Management. In this role, you will be responsible for managing all aspects of day-to-day operations of the Behavioral Health UM program, including adherence to regulatory compliance and direct oversight of performance quality. Our leadership model focuses on developing great leaders at all levels and creating opportunities for our people to grow—personally, professionally, and financially. We seek leaders energized by creative and critical thinking, building and sustaining high-performing teams, achieving results ethically, and fostering continuous learning.
Your Knowledge and Experience
Current unrestricted CA license (LCSW, LMFT, LPCC, PhD/PsyD, or RN with Behavioral Health experience) required; requires a bachelor's degree
At least ten (10) years of relevant experience
Four (4) years of management experience, including supervision of clinical staff
Three (3) years conducting Utilization Management for a health plan
Strong understanding of behavioral health utilization management, including application of multiple standardized clinical criteria sets such as MCG guidelines, nonprofit association guidelines, and various Medicare guidelines
#J-18808-Ljbffr