Associate Director, Utilization Management - Behavioral Health - Massachusetts only

Job description

Job Summary: The Associate Director, Utilization Management – Behavioral Health assists UM leadership in leading and managing all functions within behavioral health management to ensure consistent, efficient delivery of services throughout the healthcare continuum and demonstration of positive outcomes. Essential Functions: - Collaborate with market and enterprise leaders to support development and knowledge transfer for Behavioral Health UM - Monitor effective use of prior authorizations, policies, and benefits to ensure consistent, effective and efficient delivery to members while meeting regulations and internal financial objectives - Facilitate and promote problem identification, analysis, and resolution - Proactive monitoring of regulatory requirements and meet State contract requirements for existing and new populations - Ensure Behavioral Health UM programs and operational processes are properly developed and aligned to the organization’s strategic goals - Determine benchmarks, goals and outcomes for staff and implement an accountability system - Monitor CQI activities in accordance with regulatory requirements and accreditation standards - In partnership with UM leadership,...