Behavioral Health Utilization Care Manager

The Behavioral Health Utilization Care Manager is responsible for assuring that the system of care is accessible, effective, efficient and appropriate for individuals and families seeking services.

Essential Job Functions

• Review, analyze, trend and report utilization data of individuals receiving behavioral health services
• Identify, recommend and assist in implementing programmatic and system changes designed to further develop and improve system of care through acute care meetings, care coordination, etc.
• Provide training and technical assistance related to utilization management/care coordination.
• Assure compliance with provider and CFBHN contractual requirements, managing entity accreditation requirements, annual audit requirements and laws, regulations and rules that govern the provision of behavioral health services
• Participate in and/or chair CFBHN Utilization Committee and other associated CFBHN meetings

Required Education/Experience

• Master’s degree in social work, public or business administration, public health or related field or Registered Nurse 
• Behavioral health license required LMHC, LCSW, LMFT
• Three years’ experience in utilization management or human services program management that includes oversight of admissions, census, discharges and budget

Required Knowledge, Skills & Abilities

Position Specific

• Exceptional skills in utilization data analysis
• Understanding of different funding sources for behavioral health care (Medicaid, commercial insurance) as well as state and federal funding
• In-depth understanding of system of care principles and values
• Knowledge of federal and state regulations related to the provision of mental health and substance services
• Knowledge of the principles and practices of collaborative quality improvement processes

General

• Ability to manage multiple tasks and prioritize to meet deadlines
• Knowledge of Microsoft Office suite as applicable to the position
• Ability to travel as required by the position