Director, Clinical Services
Company: Beacon Health Options
Posted on: September 16, 2020
Beacon Health OptionsJob Category: Clinical - Care MgmtReq #:
DIRCL03033Schedule: Full TimeLocation: CA - CypressWe Help People
Live their Lives to the Fullest Potential!
For more than 30 years, Beacon has changed the way people live with
behavioral health conditions. Today, we are the undisputed leader
in behavioral health management, serving 40 million people across
all 50 states. At Beacon, we are committed to delivering a
'world-class' candidate experience from the moment you click
'Apply'! Our goal is to help you reach your fullest potential,
while utilizing your talents and expertise to help us deliver on
Do you have a passion for helping others? If so, we are looking for
Beacon is currently seeking a Director, Clinical Services a highly
organized and compassionate professional to join our team West
Region.The Director, Clinical Services is responsible for clinical
oversight of Utilization Management and Intensive Case Management
programs for their designated teams. The primary focus of this
position is to ensure that the delivery of quality clinical care
and service to health plan members meets NCQA, URAC, and State,
Federal and contractual requirements. The Director, Clinical
Services works in collaboration with the AVP, Clinical Services to
ensure the clinical operational needs of the organization are
What does a typical day look like?
- Clinical oversight of all Utilization Management (UM) and
Intensive Case Management (ICM) programs in the West Region.
- Participates in and oversees compliance with internal audits
and external client UM audits.
- Identifies opportunities to streamline workflows that result in
accurate, high quality production standards and improved results in
cost savings, or outcomes measurement.
- Complete annual evaluations and program descriptions for UM
- Development of custom UM reports if indicated and monitors all
UM key performance indicators.
- Tracks and monitors all metrics related to UM program,
implements plans for improvement as necessary.
- Collaborates and helps coordinate Peer Review process.
- Oversight of the development of and adherence with
organizational and state specific UM policies and procedures.
- Monitors the census across all lines of business.
- Provides direction to Managers in the reporting and analysis of
plan specific UM metrics.
- In collaboration with the AVP, Clinical monitors utilization
management trends and formulates strategies to manage costs.
- Participates in new business opportunities including requests
- Directs UM programs in the development of clinical programming
to improve the health outcomes of the members we serve.
- Represents Beacon at client meetings regarding clinical
- Resource to the AVP, Quality on all NCQA and URAC initiatives
- Periodic consultation with practitioners in the field through
attendance at site visits, professional meetings and conferences as
well as through membership on various committees, i.e. Provider
Advisory, Clinical Management, etc. to which practitioners are
- Performs special projects and other duties as assigned and
What you Contribute?
Education: Master's Degree or higher in a health related field
Licensure: Independently licensed behavioral health clinician
required (RN, LCSW, LMFT, PhD or PsyD)
- Must be an independently licensed behavioral health clinician
and practice within the scope of their licensure with a minimum of
5 years behavioral health /managed care experience.
- Required proof on date of hire. Re-verification will take place
no less than every 3 years.
Knowledge, Skills & Abilities:
- A minimum of 5-7 years combined direct behavioral health,
supervisory and/or managed care experience required.
- Excellent written and oral communication skills
- Knowledge ofUtilization Management and Intensive Case
Management programs is required
- Self-motivated, able to prioritize multiple issues, excellent
organizational skills, ability to track multiple projects/tasks and
follow through as needed
- Leadership skills and supervisory experience, including the
ability to develop team performance
- Ability to manage and coordinate with internal and external
- Demonstrated leadership skills and experience, including the
ability to work cross-functionally, build consensus and develop
- Demonstrated understanding of CQI
- Knowledge of CQI principles and ability to manage change
- Ability to manage time-sensitive projects and meet
- Ability to identify opportunities for improvements and
recommend and implement innovative solutions
- Able to work collaboratively with internal staff and external
- Must be detail oriented; able to work independently in an ever
What Makes Us Different?
- Here, it's not just a job - it's an opportunity to change
- Our employees are learners, innovators and original
- Our mission and values guide the way we treat our members,
providers and each other.
What We Have to Offer:
- Healthcare benefits available starting day 1!
- Health & wellbeing incentives, such as gym membership
- 401K with company match to help reach your future financial
- Generous PTO, because we know life happens outside of work
- Tuition reimbursement so you can keep reaching your fullest
If Beacon sounds like the place for you, what are you waiting for?
Apply with us today to get started!
Beacon Health Options is proud to be an Equal Opportunity and
Affirmative Action Employer as well as a Drug Free and Tobacco Free
Work Environment. EOE/AA/M/F/Veterans/Disabled
At Beacon Health Options, our candidate's data privacy is a top
priority. Our recruiting team conducts all communications using
official company email (@BeaconHealthOptions.com). Only candidates
who have applied for an open position through our Careers page
(careers.beaconhealthoptions.com) will be engaged in our interview
process. Beacon conducts all interviews in person or over the
phone. At no time during the recruiting process will any Beacon
recruiter request any financial or personally identifiable
information from you.
Keywords: Beacon Health Options, Cypress , Director, Clinical Services, Executive , Cypress, California
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