Utilization Management Supervisor — Hybrid/Remote

Oakland Community Health Network; Troy (MI); Hybrid; USD 70,000 - 88,000; Full time

Benefits offered by this job

Hybrid (onsite/remote) schedule

Job summary

Oakland Community Health Network seeks a Supervisor of Utilization Management to lead the UM team and ensure compliant, timely reviews. You will supervise UM Clinical Analysts and drive policy development, audits, and quality improvement across the provider network.

The role requires a Master’s in a mental health field, Michigan licensure, and 3+ years of post-graduate experience, with preferred CMHSP/PIHP/MCO exposure and supervisory background.

Qualifications

• Master's degree in mental health field.
• Current, unrestricted State of Michigan professional license in one of the following disciplines: Licensed Psychologist (LLP or LP), LMSW, LPC, LMFT, or RN.
• CADC, CAADC, or Development Plan preferred.
• Must maintain CDTP eligibility, including 24 hours of annual child-specific training.
• Minimum of three years of relevant post-graduate clinical experience.
• Preferred CMHSP/PIHP/MCO, hospital, or behavioral health experience and supervisory experience.
• Knowledge of Michigan Mental Health Code and Medicaid rules.

Responsibilities

• Provide administrative and supervisory oversight for UM Clinical Analysts.
• Lead and develop UM staff, and ensure compliance with policies and regulatory requirements.
• Monitor authorization decisions and other utilization management reviews.
• Develop, implement, and maintain UM policies, procedures, and protocols.
• Collaborate with providers, partners, and internal departments on complex cases.
• Support audits, quality improvement activities, and performance reporting.
• Provide training and guidance on UM practices to staff and network.

Education

Master's degree in mental health field

Job description

Oakland Community Health Network seeks a Supervisor of Utilization Management to lead the UM team and ensure compliant, timely reviews. You will supervise UM Clinical Analysts and drive policy development, audits, and quality improvement across the provider network.

The role requires a Master’s in a mental health field, Michigan licensure, and 3+ years of post-graduate experience, with preferred CMHSP/PIHP/MCO exposure and supervisory background.