Your RoleThe Behavioral Health (BH) Utilization Management (UM) team manages prior authorization and concurrent review for members seeking mental health and/or substance use disorder treatment. The Operations Specialist, Experienced will report to the Sr. Manager, BH UM. In this role you will be the subject matter expert for the BH UM team with projects and deliverables that support business needs for our Fully Insured products.Your WorkIn this role, you will:Act as a subject matter expert to review operational workflows of high degree of complexity, identifying problems and developing improvements, modifications, and enhancementsWork with business leaders to identify requirements and make recommendationsDevelop and evaluate tools and materials that enhance operating efficiency, accuracy, and technical skill levels of unit staffMay be responsible for entire projects or processes within job areaTrack and communicate workflow and system changes to appropriate sources and coordination of training and documentation needsNotifies appropriate managers on issues and problems requiring immediate attention and provides recommendations for resolutionResponsible for improving processes to enhance performance of the job areaDevelop and generate reports ranging from routine to moderately complex for management reviewIdentify and implement process enhancements and efficiency gains that can be realized on an ongoing basisSupport testing to ensure system functionalityMaintain ongoing relationships with vendor partners to ensure compliance with regulations, SLAs and performanceYour Knowledge and ExperienceRequires practical knowledge of Utilization Management functions including prior authorization/concurrent reviewRequires a college degree or equivalent experienceRequires 3 years of prior relevant experienceUnderstanding of behavioral health facility-based levels of care preferredExperience with Prior Authorization preferredExperience working with project management and business change readiness preferredStrong written and verbal communication skillsStrong critical thinking skills and attention to detail