UM Senior Care Manager - West Region in Cypress, CA at Beacon Health Options

Date Posted: 7/13/2018

Job Snapshot

Job Description

About the Position:

We are currently seeking a dynamic UM Senior Care Manager to join our team in Cypress, CA! The Senior UM Clinician provides support and contributes to the training of less experienced UM staff for current and new business. The Senior UM Clinician performs clinical audits for the inpatient administrative team. The Senior UM Clinician supports clinical initiatives, implementations, NCQA, URAC and participates in internal and external meetings.

Position Responsibilities:

  • Supports new business and new staff through training on systems (e.g., FlexCare, RainTree, CareConnect) documentation, policies and procedures and standards of operation.
  • Expectation of Senior UM Clinical to develop expertise in UM policies and procedures for working all systems (e.g., CareConnect, RainTree and FlexCare).
  • Assists in the development of training materials.
  • Conducts regular audits of inpatient admin intake, discharge, and letter teams to ensure admin staff are following policies, procedures, and structured clinical algorithm.
  • Serves as a liaison between inpatient admin and clinical teams.
  • Supports Director of UM Administrative Services and VP of UM West in new business and internal clinical operations implementations.
  • Provides assistance with clinical system enhancement request, testing and training.
  • Attends internal and external meetings as needed.
  • Some travel may be required based on business need.
  • Assists with NCQA, URAC and other QI initiatives to support the UM Clinical Teams.
  • Provides assistance with Service Center Clinical Policy Review, Medical Necessity and provides training.
  • Contributes to Corporate Clinical workgroups.
  • Adheres to all Beacon policies and procedures and standards of operations.
  • Completes all required and assigned trainings.
  • Attends all mandatory company or department meetings.
  • Reports to each scheduled shift and commences work and performs essential job functions at the start of each schedule shift.
  • Displays a positive, constructive, and helpful demeanor that is conducive to a safe and respectful work environment.
  • Acts as a mentor to junior team members by leading by example and guiding with a sense of integrity and team work.
  • Assists management with identifying opportunities for staff improvement, high performing team members, and training needs of team members.
  • Assists team members and offers suggestions to improve processes, culture, or work environment.
  • Available to work on site at Service Center as needed.
  • Performs special projects and other duties as assigned and required.

Position Requirements:

  • Education: Master’s Degree or higher in a health related field required
  • Licensures: Current, valid, unrestricted clinical license required (RN, LCSW, MFT, LPCC, PhD or PsyD) is required and incumbent must practice within the scope of license required
  • Relevant Work Experience: 2 years of combined direct behavioral health clinical and managed care required

To Apply:

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Beacon Health Options is proud to be an Equal Opportunity and Affirmative Action Employer as well as a Drug Free and Tobacco Free Work Environment.  EOE/AA/M/F/Veterans/Disabled