GENERAL SUMMARY
Responsible for the day-to-day supervision of the behavioral health department staff. Serves in an active managerial role to assist in the development, implementation, and evaluation of the utilization management process. Provides direct services to members as necessary to ensure internal and external customer requirements are achieved.
ESSENTIAL RESPONSIBILITIES
- Provides daily oversight and direction to behavioral health and/or EAP department staff. Responsible for coordinating work and work flow. Provides direction, leadership, and support to staff. Serves as senior member in care management unit.
- Assesses quality of services provided to members. Assists senior management with operations planning and monitoring. Responsible for recommending and implementing changes that would improve or enhance the delivery of service.
- Responsible for continuity of care in the provision of comprehensive case management services. Coordinates communication with behavioral healthcare providers, members, and their families.
- May provide direct services to members as necessary in the development of cost-effective care plans for high-risk, high-cost cases by working with behavioral healthcare providers, members, and their families.
- Monitors and evaluates case managers’ performance, efficiency, and productivity according to quality management standards and performance guarantees.
- Maintains documentation in member file in an acceptable format to ensure accurate records and reporting.
- Assists with quality improvement and utilization improvement activities as required.
- Takes an active role in standing and ad hoc committees and work groups to address efficiency concerns or new processes to ensure effective planning and information transfer.
- Recruits, develops, and motivates staff. Initiates and communicates a variety of personnel actions including employment, termination, performance reviews, salary reviews, and disciplinary actions.
- Performs other duties as required.
Qualifications:
JOB SPECIFICATIONS
- Must be a licensed psychologist in the state of Missouri with a PhD or PsyD or Registered Nurse (RN).
- Minimum (5 years) clinical experience required.
- Previous clinical supervisory experience preferred.
- Previous experience working in utilization management or a managed care environment preferred.
- Demonstrated written and verbal communication skills
- Ability to use standard computer software packages and applications.
Coventry Health Care is an Affirmative Action/Equal Opportunity Employer, and we are committed to building a talented and diverse team.
Job: Professionals
Primary Location: St. Louis, MO, US
Organization: 51000 - MHNet Specialty Services, LLC
Schedule: Part-time
Job Posting: 2013-01-10 00:00:00.0
Job ID: 1212543