Behavioral Health Utilization Management Clinician

This is a fully remote position, open to applicants in Idaho, +3 more states.

📋 Description

• Conduct thorough prospective, concurrent, and retrospective utilization management evaluations.

• Ensure compliance with medical necessity and policy guidelines.

• Utilize clinical knowledge and evidence-based standards to reach decisions.

• Consult with physician advisors when necessary.

• Collaborate with interdisciplinary teams, case management, and other departments to facilitate care transitions and address issues.

• Respond promptly and accurately to inquiries from both internal and external sources.

• Deliver outstanding customer service.

• Identify opportunities for improvement and engage in quality enhancement initiatives.

• Maintain precise and consistent documentation.

• Prioritize tasks to adhere to performance metrics and organizational goals.

• Safeguard confidential information.

• Communicate professionally with members, providers, and regulatory bodies.

⛳️ Requirements

• Master’s Degree in a Behavioral Health Discipline.

• Minimum of 3 years in utilization management or behavioral healthcare management.

• Equivalent combination of education and experience is acceptable.

• At least 3 years of direct clinical experience in Behavioral Health as an independently licensed Master's-level clinician.

• Background in Psychology, Counseling, Social Work, Marriage, or Family Therapy.

• Current and unrestricted clinical license in the state of residence.

• Must hold a license in WA, OR, ID, or UT and be open to licensing in additional states.

• Proficient in advanced behavioral healthcare settings, including inpatient facilities, residential programs, and partial hospitalization.

• Awareness of trends, advancements, and contractual agreements in the health insurance sector.

• Skilled in Microsoft Office, Outlook, and online research capabilities.

• Familiarity with electronic healthcare documentation systems.

• Strong verbal, written, and interpersonal communication abilities.

• Capacity to interpret and convey complex policies and procedures.

• Excellent organizational and time management capabilities.

• Critical thinking and informed decision-making proficiency.

• Background check required.

• Access to a personal mobile device for Multi-Factor Authentication.

• Wired internet connection with a minimum upload speed of 5Mb and download speed of 10Mb; satellite or cellular internet is not acceptable.

🏝️ Benefits

• Competitive salary.

• Comprehensive benefits package.

• 401(k) plan with a substantial company match.

• Opportunities for bonuses.

• Medical, dental, and vision coverage for employees and eligible family members, including mental health benefits.

• Annual employer contribution to a health savings account.

• Generous paid time off policies.

• 10 company-paid holidays.

• Retirement plan with company match and potential discretionary contributions based on company performance, with no vesting period.

• Up to 12 weeks of paid parental leave following 12 months of continuous service.

• Award-winning wellness programs that incentivize participation.

• Employee Assistance Fund.

• Benefits for commuting and parking.

• Options for remote work.

• Requirement for a wired internet connection for remote employees.

• Employee resource groups.

• Community outreach initiatives.

• Support for personal mobile devices for Multi-Factor Authentication.