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 members experiencing substance use disorders throughout the entire care continuum.

• Perform thorough clinical assessments and utilization reviews.

• Create personalized care plans and facilitate suitable levels of care and recovery-oriented treatment.

• Encourage member engagement and recovery by providing education, advocacy, and coordinated interventions.

• Assess and process authorization requests while evaluating medical necessity.

• Coordinate discharge planning and referrals to appropriate care levels and community resources.

• Collaborate with members, providers, health plans, and community resources to overcome care barriers.

• Ensure adherence to regulations through precise clinical documentation and effective use of care management systems.

• Engage in quality improvement initiatives.

• Maintain up-to-date clinical knowledge and industry expertise.

⛳️ Requirements

• A current, active, and unrestricted state license from a U.S. state or territory that allows for independent practice, permitting assessments as a Clinical Social Worker, Marriage and Family Therapist, Professional Counselor, Clinical Psychologist, or Registered Nurse.

• Licensure in the state where the business operates and/or in additional states as mandated by law, regulation, or contract.

• A minimum of 2 years of direct clinical care experience in substance use disorder treatment, care management, utilization management, or a related field.

• Proven understanding of substance use disorders, co-occurring mental health issues, treatment modalities for SUD, and recovery principles.

• Familiarity with ASAM Criteria and the application of level of care determinations in substance use disorder treatment.

• Exceptional verbal and written communication skills, along with strong interpersonal abilities.

• Proficient in computer skills and keyboarding, including familiarity with Microsoft Office Suite.

• Capability to document information while simultaneously taking notes over the phone.

• Ability to understand medical policy and criteria and effectively convey health information.

• Must successfully pass a background check upon hiring and throughout employment, which includes criminal history, employment verification, education verification, sanctions, prohibited parties, sex offender registry, and a 10-Panel Drug Screen.

• Self-motivated individual, capable of taking initiative to meet objectives.

• Ability to work independently to fulfill caseload requirements and achieve team goals.

• Demonstrated commitment to professional growth through specialization, certification, or advanced degrees.

• Reliable high-speed internet service with a minimum download speed of 20 Mbps, upload speed of 5 Mbps, and maximum latency of 100 milliseconds, set up before employment begins.

• A quiet workspace with minimal background noise for calls.

• A hardwired internet connection.

• Capacity to sit for prolonged periods and perform repetitive typing and computer tasks.

🏝️ Benefits

• Annual performance-based discretionary incentive.

• Medical, dental, and vision insurance coverage.

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

• Company-paid life and disability insurance.

• Paid parental leave and wellness incentives.

• Generous paid time off, including time for volunteering.

• Flexible spending accounts for healthcare and dependent care expenses.

• Opportunities for professional development and tuition reimbursement.

• Flexibility for remote work (role-dependent).

• Equipment provided by the company.

• Opportunities for significant personal and professional growth.