Utilization Management Manager – Behavioral Health (BCBA)

Location: Remote in California

We have an opportunity to join the Alliance as the Utilization Management Manager – Behavioral Health (BCBA) in the Utilization Management department.

Reporting to the Utilization Management Director, this position:
• Provides management oversight of the Utilization Management (UM) Behavioral Health Therapy (BHT) Unit
• Manages and leads the BHT team, acts as a subject matter expert, and provides guidance related to BHT utilization management activities and departmental operations
• Performs BHT program effectiveness evaluation
• Manages, supervises, mentors, and trains assigned staff

We determine medical necessity and benefit coverage for our members based on industry standards.

To read the full position description, and list of requirements please visit our careers page

Knowledge of:
o Behavioral Health Therapy (BHT) best practices
o BHT authorization and documentation requirements
o Managed care plan behavioral health responsibilities
o Behavior Analyst Certification Board ethical guidelines
o Principles and practices of project management

Ability to:
o Train, mentor, supervise, and evaluate the work of staff, promote an atmosphere of teamwork and cooperation, and motivate staff to achieve goals and objectives
o Organize and prioritize the work of others, delegate effectively, and follow up on work assignments
o Act as a technical resource and explain regulations, processes, and programs related to area of assignment
o Manage the development and implementation of policies, procedures, projects, systems, and programs
o Develop work plans and workflows and organize and prioritize team activities
o Manage multiple projects simultaneously, organize work, and achieve goals and timelines
o Analyze, interpret and apply legal, regulatory, and contractual language, policies, procedures and guidelines, and legislative and regulatory directives

Education and Experience:
o Possession and continued maintenance of current and unrestricted certification as a Board Certified Behavior Analyst (BCBA) issued by the Behavior Analyst Certification Board (BACB)
o Master’s degree in Behavior Analysis or other field of study that has met the requirements for BCBA certification by the BACB and a minimum of four years of experience providing behavioral health therapy to children diagnosed along the autism spectrum, including a minimum of two years of experience in a managed care environment and some supervisory or lead experience (a Ph.D. in Behavior Analysis may substitute for two years of the required experience); or an equivalent combination of education and experience may be qualifying

• We are in a hybrid work environment, and we anticipate that the interview process will take place remotely via Microsoft Teams.
• While some staff may work full telecommuting schedules, attendance at quarterly company-wide events or department meetings will be expected.
• In-office or in-community presence may be required for some positions and is dependent on business need. Details about this can be reviewed during the interview process.

The full compensation range for this position is listed by location below.

The actual compensation for this role will be determined by our compensation philosophy, analysis of the selected candidate’s qualifications (direct or transferrable experience related to the position, education or training), as well as other factors (internal equity, market factors, and geographic location).

Compensation Range
$119,958—$174,658 USD

• Medical, Dental and Vision Plans
• Ample Paid Time Off
• 12 Paid Holidays per year
• 401(a) Retirement Plan
• 457 Deferred Compensation Plan
• Robust Health and Wellness Program
• Onsite EV Charging Stations
We are a group of over 500 dedicated employees, committed to our mission of providing accessible, quality health care that is guided by local innovation. We feel that our work is bigger than ourselves. We leave work each day knowing that we made a difference in the community around us.

Join us at Central California Alliance for Health (the Alliance), where you will be part of a culture that is respectful, diverse, professional and fun, and where you are empowered to do your best work. As a regional non-profit health plan, we serve members in Mariposa, Merced, Monterey, San Benito and Santa Cruz counties.

The Alliance is an equal employment opportunity employer. Qualified applicants will receive consideration for employment without regard to race, color, religion, sex (including pregnancy), sexual orientation, gender perception or identity, national origin, age, marital status, protected veteran status, or disability status. We are an E-Verify participating employer
At this time the Alliance does not provide any type of sponsorship. Applicants must be currently authorized to work in the United States on a full-time, ongoing basis without current or future needs for any type of employer supported or provided sponsorship.

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