<p style="text-align:left">You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility.</p><b>Position Purpose:</b> Supervises the behavioral health (BH) utilization review clinicians to ensure appropriate care for members and supervises day-to-day activities of BH utilization management team.<ul><li>Monitors behavioral health (BH) utilization review clinicians and ensures compliance with applicable guidelines</li><li>Monitors and tracks UM BH resources to ensure adherence to performance, quality, and efficiency standards</li><li>Works with BH utilization management team to resolve complex BH care member issues related to BH</li><li>Maintains knowledge of regulations, accreditation standards, and industry best practices related to BH utilization management</li><li>Works with BH utilization management team and senior management to identify opportunities for process and quality improvements within utilization management</li><li>Educates and provides resources for BH utilization management team on key initiatives and to facilitate on-going communication between BH utilization management team, members, and providers</li><li>Works with the BH senior management to develop and implement UM policies, procedures, and guidelines that ensure appropriate and effective utilization of healthcare services</li><li>Evaluates BH utilization management team performance and provides feedback regarding performance, goals, and career milestones</li><li>Provides coaching and guidance to the BH utilization management team for optimal performance management and provides counseling and corrective action when required</li><li>Assists with onboarding, hiring, and training BH utilization management team members</li><li>Attends company meetings in absence of people leader</li><li>Acts as primary contact for escalated calls/issues that require research or special handling</li><li>Leads and manage others in a matrixed/cross functional environment</li><li>Leads and champions change within scope of responsibility</li><li>Presents information and responds to questions from peers, leaders and internal/external customers</li><li>Performs other duties as assigned.</li><li>Complies with all policies and standards.</li></ul><p><b>Education/Experience:</b> Requires Graduate of an Accredited School of Nursing or Bachelor's degree and 4+ years of related experience.<br><br>License to practice independently, and/or have obtained the state required licensure as outlined by the applicable state required.<br>Knowledge of BH utilization management principles preferred.<br>Prior supervisory experience preferred preferred.<br>Understanding of medical necessity criteria for a broad range of BH services preferred.<br><br><b>License/Certification:</b></p><ul><li>LCSW- License Clinica