**Company :**
Highmark Inc.
**Job Description :**

**JOB SUMMARY**

This job plays a crucial role in the corporation’s success, and under direction by the chief medical officer and in collaboration with the senior director for behavioral health, works closely with all divisions and departments within the corporate structure to provide clinical consultation and support with regard to the behavioral health and addiction services program strategy and development, compliance with accepted medical standards, and practitioner/provider education. The incumbent is an integral part of the behavioral health utilization management team and assists utilization management staff by direct supervision or as otherwise appropriate to ensure delivery of quality and cost–effective care, member/provider satisfaction, and quality outcomes.

**ESSENTIAL RESPONSIBILITIES**

+ Provide utilization management reviews and clinical support for Medicaid, Medicare (DSNP) member...