Davita Inc.
Sr. Manager, Behavioral Health Utilization Management
Davita Inc., Los Angeles, California, United States, 90079
Your Role
The Behavioral Health Utilization Management (UM) team performs prior authorization and concurrent reviews by applying evidence-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. This role involves managing all aspects of the day-to-day operations of the Behavioral Health UM program, including ensuring regulatory compliance and overseeing performance quality. Our leadership model focuses on developing great leaders at all levels and creating opportunities for personal, professional, and financial growth. 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; a bachelor's degree is also required.
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 Medicare guidelines.
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The Behavioral Health Utilization Management (UM) team performs prior authorization and concurrent reviews by applying evidence-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. This role involves managing all aspects of the day-to-day operations of the Behavioral Health UM program, including ensuring regulatory compliance and overseeing performance quality. Our leadership model focuses on developing great leaders at all levels and creating opportunities for personal, professional, and financial growth. 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; a bachelor's degree is also required.
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 Medicare guidelines.
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