Behavioral Health Manager

Overview The Manager, Behavioral Health is responsible for the day-to-day operational management of the Behavioral Health team and supports the Director, Behavioral Health in the administration of clinical operations, quality activities, staff oversight, and regulatory compliance. This role oversees implementation of case management and utilization management workflows for Behavioral Health, serves as a clinical resource for staff, supports policy and procedure implementation, and helps monitor operational performance, productivity, and service standards. The Manager provides direct oversight of assigned staff and helps ensure work allocation, staff utilization, and team engagement remain aligned with departmental expectations.

JOB SPECIFICATIONS AND CORE COMPETENCIES

40% Department Management – Supervises day-to-day operations of the Behavioral Health team to support productivity, quality, and service expectations.

• Monitors staff assignments, daily workflow, pended cases, and workload distribution to support timely case management and utilization management operations.
• Reviews productivity and operational reports and escalates trends, barriers, and resource concerns to department leadership.
• Conducts routine audits of UM/CM staff and coordinators. Increases audit frequency when performance indicators, compliance concerns, or quality findings warrant additional oversight.
• Coordinates clinical rounds and coaches staff in preparing case summaries and presenting cases.
• Supports onboarding, orientation, and ongoing training for assigned staff.
• Provides operational support during staffing shortages or high-volume periods.

40% Cross-functional Duties – Communicates operational issues, staff trends, and process opportunities to the Director, Behavioral Health and assists with follow-up actions as needed.

• Investigates and helps resolve claims, authorization, and workflow issues within scope and escalates complex matters appropriately.
• Monitors turnaround time compliance for UM and CM processes and works with staff to mitigate and prevent non-compliance.
• Coordinates and monitors referrals to medical case management, high-risk perinatal, disease management, and quality improvement teams when appropriate.
• Supports staff in discharge planning needs of hospitalized members.
• Supports staff with clinical presentations to medical directors.
• Participates in departmental workgroups, committees, and initiatives to improve the health and quality of clinical care and service delivery to community members and providers.

20% – Actively contributes to achievement of departmental goals, as identified in the department annual business plan, including specific departmental process improvement plans, reporting support, staff development activities, and other duties as assigned.

REQUIRED QUALIFICATIONS

Education/Specialized Training/Licensure: Master’s degree in social work or counseling required. Current unrestricted license in the state of Texas: LCSW, LMSW, LMFT, or LPC Work Experience (Years and Area): 5 years of combined case management and utilization management experience Management Experience (Years and Area): 2 year of direct supervisory, team lead, or management experience in a managed care environment. Software Proficiencies: Advanced PC skills, MS Word, MS Excel, MS Outlook #J-18808-Ljbffr Community Health Choice