Vice President, Clinical Operations - Behavioral Health UM

Centene Corporation•Remote-FL, MO

2d•$171,900 - $326,900•Hybrid

About The Position

At Centene, we connect people to the care they need to live healthier lives — and the work you do here makes that impact real every day. You’ll take on meaningful challenges that directly support individuals, families, and communities, building your skills while making healthcare more accessible and effective. It’s work with a purpose you can see, backed by a team committed to improving lives well beyond the workday.

Requirements

Master's Degree in Behavioral Health, Psychology, Public Health/Administration, related field or RN license required.
8+ years of clinical and operations experience in the behavioral health industry required.
Previous management experience including responsibilities for hiring, training, assigning work and managing performance of staff.
Unrestricted license as a LCSW, LMFT, LPC, PhD, PsyD or RN required.
Or equivalent experience acquired through accomplishments of applicable knowledge, duties, scope and skill reflective of the level of this position.

Responsibilities

Oversee and direct all clinical operations, including care management and coordination, and utilization management
Establish the business unit’s clinical strategic vision, objectives, policies and procedures to ensure delivery of cost effective, clinically appropriate services in all markets.
Monitor performance results against established metrics and benchmarks and recommend improvement opportunities.
Serve as the subject matter expert and participate in all new implementations.
Oversee utilization and care management across all markets.
Participate in customer, health plan, and QI meetings.
Oversee the production of reports required by the contract and management.
Collaborate with various departments to resolve provider claims issues.
Ensure effective care is delivered to members while achieving utilization management goals.
Oversee annual budget for clinical operations.
Drive efforts to increase staff expertise at shaping providers to perform more effectively in the delivery of care, including development of training programs.
Performs other duties as assigned.
Complies with all policies and standards.