Teams at Lucet

Leads regional clinical operations for substance use disorder utilization and care management services. Oversees clinicians, team performance, resource management, quality, regulatory and contractual compliance, audits, reporting, and continuous improvement. Builds high-performing teams and collaborates with health plans, providers, clients, and internal stakeholders. Serves as a subject matter expert for complex SUD cases while supporting evidence-based, recovery-oriented, member-centered care.

Reviews behavioral health authorization requests and makes medical necessity and level-of-care determinations using clinical judgment and evidence-based criteria. Coordinates care with members, families, providers, and clients, including discharge planning and access to services. Documents reviews accurately, maintains compliance with regulatory and accreditation standards, handles telephonic provider contacts, and manages caseloads independently in a remote work environment.

Leads enterprise quality management, performance improvement, compliance, and quality analytics programs. Develops quality strategy, monitors clinical and operational measures, translates data into executive insights, and drives improvements in outcomes, member experience, patient safety, regulatory performance, and HEDIS and Medicare Stars results. Partners with clinical, operational, health plan, regulatory, and accreditation stakeholders while leading audits, risk mitigation, change management, and a high-performing quality team.