Manager, Behavioral Health Um And Programs

Harvard Pilgrim Health Care Inc

Remote, US
Base: $98,659.20 - $147,988.80; bonus/equity: vari...
Fully remote
Manage behavioral health functional team
Ensure regulatory compliance adherence
Oversee utilization management processes
The Manager, Behavioral Health position at Harvard Pilgrim Health Care Inc. involves leading a team within the Behavioral Health department, overseeing clinical processes, and ensuring compliance with healthcare regulations. The role is remote and emphasizes collaboration, data-driven decision-making, and the integration of behavioral health into broader healthcare initiatives

Job Summary

  • The Manager leads a Behavioral Health functional team while managing clinical processes to support the department's goals.
  • This role requires ensuring adherence to federal, state, and national regulations while overseeing utilization management and care coordination.
  • Point32Health offers a comprehensive total rewards package including medical, dental, vision, retirement plans, and paid time off.

Matching Summary

Match Score: 85

The Manager, Behavioral Health position at Harvard Pilgrim Health Care Inc. involves leading a team within the Behavioral Health department, overseeing clinical processes, and ensuring compliance with healthcare regulations. The role is remote and emphasizes collaboration, data-driven decision-making, and the integration of behavioral health into broader healthcare initiatives.

Salary

Base: $98,659.20 - $147,988.80; Bonus/Equity: Variable pay eligible; Benefits: Medical, dental, vision, retirement, PTO, life insurance

Skills & Requirements

Must-have

  • Manage Behavioral Health functional team
  • Ensure regulatory compliance adherence
  • Oversee utilization management processes
  • Develop clinical care coordination initiatives
  • Conduct performance appraisals and coaching

Nice-to-have

  • Experience with MassHealth or MCOs
  • Knowledge of NCQA accreditation standards
  • Strong cross-functional collaboration skills
  • Background in public health plans
  • Ability to drive quality improvement

Key Requirements

  • Hire, train, and manage staff effectively
  • Monitor utilization management metrics and goals
  • Review clinician case audits and IRR results
  • Collaborate with MassHealth and other managed care entities

Work Rights

Not specified

Tailored Resume

Cover Letter