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Evolent Health Manager, Behavioral Health in Topeka, Kansas

It’s Time For A Change…

Your Future Evolves Here

Evolent Health has a bold mission to change the health of the nation by changing the way health care is delivered. Our pursuit of this mission is the driving force that brings us to work each day. We believe in embracing new ideas, challenging ourselves and failing forward. We respect and celebrate individual talents and team wins. We have fun while working hard and Evolenteers often make a difference in everything from scrubs to jeans.

Are we growing? Absolutely – about 40% in year-over-year revenue growth in 2018. Are we recognized? Definitely. We have been named one of “Becker’s 150 Great Places to Work in Healthcare” in 2016, 2017, 2018 and 2019, and one of the “50 Great Places to Work” in 2017 by Washingtonian. We recognize employees that live our values, give back to our communities each year, and are champions for bringing our whole selves to work each day. If you’re looking for a place where your work can be personally and professionally rewarding, don’t just join a company with a mission. Join a mission with a company behind it.

What You’ll Be Doing:

It’s Time For A Change…

Your Future Evolves Here

Evolent Health has a bold mission to change the health of the nation by changing the way health care is delivered. Our pursuit of this mission is the driving power that brings us to work each day. We believe in embracing new ideas, testing ourselves and failing forward. We respect and celebrate individual talents and team wins. We have fun while working hard and Evolenteers often make a difference in everything from scrubs to jeans.

Are we growing? Absolutely. We have seen about 30% average growth over the last three years. Are we recognized? Definitely. We were named one of “Becker’s 150 Great Places to Work in Healthcare” in 2016, 2017, 2018 and 2019 and are proud to be recognized as a leader in driving important Diversity and Inclusion (D&I) efforts: Evolent achieved a 95% score on its first-ever submission to the Human Rights Campaign's Corporate Equality Index; was named on the Best Companies for Women to Advance List 2020 by Parity.org; and we publish an annual Diversity and Inclusion Annual Report to share our progress on how we’re building an equitable workplace. We recognize employees that live our values, give back to our communities each year, and are champions for bringing our whole selves to work each day. If you’re looking for a place where your work can be personally and professionally rewarding, don’t just join a company with a mission. Join a mission with a company behind it.

The Manager, Behavioral Health is responsible for the coordination and efficient utilization of health care resources for the provision of quality care for Medicaid members. This position will be responsible for oversight of a team of clinical who will conduct utilization management services for a population, including prior authorization and concurrent review. The ultimate goal is to provide the right services in the right setting at the right time, within the parameters established by the various managed care programs.

Essential Functions

Oversees Behavioral Health for Utilization Management & Care Management

  • Monitors appropriate staffing ratios, productivity, and team assignments based on volumes.

  • Maintains quality and performance standards for intake fax management and triage functions of the medical management program as demonstrated by compliance with Federal, State and accreditation requirements.

  • Works with the QA and training to evaluate and implement changes based on quality audit results to identify trends and possible educational opportunities for the intake team in Pune, India.

  • Uses data to provide regular monitoring and analysis of utilization management activities to identify departmental opportunities for process improvement and improved workflow efficiencies.

  • Serves as the point of escalation for issues from the front-line staff and intake supervisor, UM.

  • Oversees day to day utilization management activities for intake fax management and triage functions.

  • Works with utilization management supervisor and other UM leaders to ensure that day to day utilization management activities are carried out in accordance with established policies and procedures.

  • In conjunction with other utilization management leadership and the Talent partner, makes staff hiring and termination decisions.

  • Alongside QA and training team, monitors staff progress through the departmental onboarding process for new utilization management staff.

  • Manage staff performance with the use of performance coaching plans, as indicated through conversations with the Talent Partner.

  • Monitor staff work queues to ensure timely processing and appropriate volume distribution.

  • Perform intake fax management and triage of authorization requests as necessary to ensure turnaround times and processing times are met.

  • Other duties, responsibilities and activities may change or be assigned at any time with or without notice

Education and Experience

  • Required to have a current license to practice independently, and/or have obtained the state required licensure as outlined by the applicable state. This includes but is not limited to licenses such as LPC, LCSW, LMFT, LMHC, LIMHP, and RN

  • 3-5 years of behavioral health experience, preferably in a hospital, community mental health center, case management, coordinating care across multiple settings and with multiple providers

  • Three to five years of supervisory or management experience overseeing care management operations

  • Proven leadership qualities including ability to train, motivate, manage, and supervise a staff of professionals.

  • Knowledge of health plan operations, including productivity management

  • Knowledge of managed care principles, HMO and Risk Contracting arrangements.

  • Knowledge of NCQA guidelines and standards

  • Experience with clinical decision-making criteria sets (i.e. Milliman, InterQual)

  • Ability to perform trending, forecasting and analysis of utilization management data and development of action plans to identify opportunities for improvement.

  • Experience with Microsoft Office Suite, spreadsheet experience a plus.

  • Strong interpersonal, oral and written communication skills.

Technical requirements:

Currently, Evolent employees work remotely temporarily due to COVID-19. As such, we require that all employees have the following technical capability at their home: High speed internet over 10 MBPS and, specifically for all call center employees, the ability to plug in directly to the home internet router. These at-home technical requirements are subject to change with any scheduled re-opening of our office locations.

“Evolent Health is committed to the safety and wellbeing of all its employees, partners and patients. We currently require all employees who may voluntarily return to our Evolent offices to be vaccinated and invite all employees regardless of vaccination status to remain working from home.

As we continue to evaluate re-opening our offices more fully and begin to have specific roles that will require face to face interaction with our providers and patients in client facilities or homes, all employees must be prepared to meet our vaccine requirements with or without accommodation at that time.”

Evolent Health is an equal opportunity employer and considers all qualified applicants equally without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran status, or disability status.

Technical requirements:

Currently, Evolent employees work remotely temporarily due to COVID-19. As such, we require that all employees have the following technical capability at their home: High speed internet over 10 MBPS and, specifically for all call center employees, the ability to plug in directly to the home internet router. These at-home technical requirements are subject to change with any scheduled re-opening of our office locations.

Evolent Health is committed to the safety and wellbeing of all its employees, partners and patients and complies with all applicable local, state, and federal law regarding COVID health and vaccination requirements. Evolent expects all employees to also comply. We currently require all employees who may voluntarily return to our Evolent offices to be vaccinated and invite all employees regardless of vaccination status to remain working from home. Certain jobs require face-to-face interaction with our providers and patients in client facilities or homes. Employees working in such roles will be required to meet our vaccine requirements without exception or exemption.

Evolent Health is an equal opportunity employer and considers all qualified applicants equally without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran status, or disability status.

Compensation Range:

The typical range of employees within the compensation grade of this position is . Salaries are determined by the skill set required for the position and commensurate with experience and may vary above and below the stated amounts.

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