Clinician, Clinical Operations – SUD

This is a fully remote position, open to applicants in United States.

📋 Description

• Deliver comprehensive care management and utilization management services for individuals with substance use disorders throughout the entire care continuum.

• Perform thorough clinical assessments and utilization reviews.

• Create personalized care plans tailored to individual needs.

• Encourage member involvement, recovery-oriented treatment, and positive health outcomes.

• Review and manage authorization requests efficiently.

• Assess medical necessity and identify suitable levels of care.

• Assist with discharge planning processes.

• Coordinate referrals to suitable care levels and community resources.

• Collaborate with members, healthcare providers, health plans, and community support services.

• Address obstacles to care via education, advocacy, and coordinated interventions.

• Maintain precise clinical documentation and utilize care management systems proficiently.

• Ensure adherence to regulatory standards.

• Engage in quality improvement initiatives.

• Commit to continuous development of clinical and industry expertise.

⛳️ Requirements

• Possess a current, active, and unrestricted state license from a U.S. state or territory, allowing for independent practice with a legal scope that includes conducting independent assessments; eligible licenses comprise Clinical Social Worker, Marriage and Family Therapist, Professional Counselor, Clinical Psychologist, or Registered Nurse.

• Have 2+ years of direct clinical care experience in substance use disorder treatment, care management, utilization management, or a similar environment.

• Demonstrate knowledge of substance use disorders, co-occurring mental health issues, SUD treatment methods, and principles of recovery.

• Familiar with ASAM Criteria and the application of level-of-care determinations for substance use disorder treatment.

• Exhibit excellent verbal, written, and interpersonal communication abilities.

• Strong proficiency in computer skills, including the Microsoft Office Suite.

• Capable of documenting information while simultaneously receiving details over the phone.

• Understand medical policies and criteria and convey health information clearly.

• Ability to pass background checks upon hiring and throughout employment, including checks for criminal records, employment history, education verification, sanctions, prohibited parties, sex offender registry, and 10-panel drug screening.

• Self-driven and capable of ensuring that goals are achieved.

• Ability to work independently to fulfill caseload requirements and team objectives.

• High-speed internet service with a minimum of 20 Mbps download, 5 Mbps upload, and a maximum latency of 100 milliseconds.

• Work in a quiet environment with minimal background noise.

• Utilize a hardwired internet connection.

• Capable of sitting for extended periods and using wired headsets and desktop equipment.

🏝️ Benefits

• Annual performance-based discretionary incentive.

• Comprehensive medical, dental, and vision coverage.

• 401(k) plan with a competitive employer match.

• Company-paid life and disability insurance.

• Paid parental leave and well-being incentives.

• Generous paid time off, including time for volunteering.

• Flexible spending accounts for healthcare and dependent care.

• Opportunities for professional development and tuition reimbursement.

• Flexibility for remote work (depending on the role).

• Potential for significant personal and professional growth.

• Company-provided equipment.

• Support for high-speed internet and fixed home workspace.