Utilization Management Review Manager

Who we are Path is a healthtech company dedicated to making mental health care work for everyone. Path takes a patient-first approach, where treatment is more accessible, personalized, and effective. With Path, it’s easy to find a high-quality therapist or psychiatric clinician who accepts insurance and is actively accepting new patients. What we’re solving Over 65 million Americans have a treatable mental health issue — that’s 1 in 5 people. Today it’s difficult to find a provider, and for those with complicated conditions, it’s nearly impossible to find coordinated care. We’re here to fix this. Our Mission Path's mission is to make mental healthcare work for everyone. We are excited to add a Clinical Review Manager to our Quality leadership team to oversee all aspects of our clinical care review (CCR) process. The CCR involves automation and manual review of medical necessity for ongoing care for clients seen at Path. This role will support a team of licensed clinical reviewers to ensure all timelines are met and lead the Care Coordination team to connect clients to higher levels of care when indicated. The person in this role will work with our BizOps & Analytic team to identify data-driven needs, and partner with the Product team to monitor and identify opportunities to improve CCR processes at scale. The Manager will interact closely with partners, providers, and other internal and external stakeholders to ensure the success of the CCR process for thousands of visits each week. We expect you to be highly competent using technology and know how to lead initiatives to manage and meet OKRs and KPIs.   Qualifications   Must-Haves  Expertise in system-wide utilization management in a healthcare setting  Foundational knowledge of clinical behavioral health care delivery  5+ years of experience in healthcare of which at least 2 of which must include utilization management experience or practice  Clinical behavioral health license  (i.e., LCSW, LMFT, LPC, LP) required (any state) Preferred  Experience with commercial insurance and a solid understanding of documentation of medical necessity criteria in outpatient clinical settings Provider or payer experience preferred  Exceptional competency with G-suite products and ability to learn new platforms quickly Demonstrated experience optimizing and scaling work flows Experience managing, hiring, developing, and motivating teams is a nice to have, not required Our Team The people of Path are what truly define our mission and determine our impact on the world. We believe in building not only a team, but a diverse community that thrives by helping each other succeed and grow and inspiring each other by taking on big challenges. For employees, Path is a 100% remote healthtech company and we’re HIRING! We're excited to bring people onto the team who are committed to raising the bar on mental health care. As Part Of Our Team, Full-Time Employees Receive The ability to work from any location within the US Competitive pay and benefits that do not change based on location 2 company-wide shutdown weeks each year to focus on self-care  Paid parental leave to support you and your family Medical, dental, and vision insurance through our employer plan Access to our 401K  Access to an Employer Assistance Plan (EAP) through our insurance plan  The equipment you need to ensure your home office sets you up for success