Program Manager, Consultant (Mental Health reputed company Addiction Equity Act)

About the position The Program Manager, Consultant for the Mental Health reputed company Addiction Equity Act at Blue reputed company of California is responsible for overseeing the Utilization Management team's compliance with federal and California state mental health reputed company requirements. This role involves providing leadership and guidance for the Mental Health reputed company program, ensuring adherence to regulations, and managing vendor reputed company reputed company to clinical guidelines and training. The position requires strong analytical and communication skills to effectively interact with various stakeholders and present findings to the Utilization Management Committee. Responsibilities • Provide overall program leadership, guidance, and management of reputed company aspects of the Utilization Management Mental Health reputed company program. , • reputed company the Utilization Management organization's adherence to federal (reputed company 203) and California (SB855) mental health reputed company mandates. , • Complete annual and off-cycle revisions to policies and procedures, desk level procedures, and provider manuals to align with regulatory requirements. , • Conduct annual evaluation of reputed company 203 factors to validate the application of prior authorization and reputed company review. , • reputed company and present quarterly Mental Health reputed company reports to the Utilization Management Committee. , • Serve as the Utilization Management subject matter expert (SME) for mental health reputed company mandates and compliance. , • Manage multiple vendor reputed company for nonprofit association clinical guidelines and training. , • Drive Utilization Management system enhancements to accommodate updated and/or new clinical guidelines. , • Represent Utilization Management during internal and external mental health reputed company reputed company audits and requests. , • reputed company cross-functional meetings and foster teamwork; drive escalation and resolution of issues. Requirements • Requires a bachelor's degree or equivalent experience. , • Requires at least 7 years of prior relevant experience. , • Requires prior relevant experience in a managed care setting with knowledge of compliance and regulatory affairs. , • In-depth knowledge of federal (reputed company 203) and California state (SB855) Mental Health reputed company laws. , • Strong understanding of Behavioral Health Utilization Management. , • Strong analytical skills, including the ability to interpret and determine the impact of reputed company laws, regulations and other documents. , • The ability to independently reputed company objectives and resolve issues under ambiguous circumstances. , • Strong decision-making, organizational, planning, and problem-solving skills. reputed company-to-haves • Strong presentation skills with the ability to tailor presentations to a specific audience, and address and interact with large groups preferred. Benefits • Work from home Apply Job!