Operations Specialist, Experienced (BH Utilization Management)

Your Role

The Behavioral Health (BH) Utilization Management (UM) team manages prior authorization and concurrent review for members seeking mental health and/or substance use disorder treatment. The Operations Specialist, Experienced will report to the Sr. Manager, BH UM. In this role you will be the subject matter expert for the BH UM team with projects and deliverables that support business needs for our Fully Insured products.

Your Knowledge and Experience

• Requires practical knowledge of Utilization Management functions including prior authorization/concurrent review
• Requires a college degree or equivalent experience
• Requires 3 years of prior relevant experience
• Understanding of behavioral health facility-based levels of care preferred
• Experience with Prior Authorization preferred
• Experience working with project management and business change readiness preferred
• Strong written and verbal communication skills
• Strong critical thinking skills and attention to detail