Utilization Management Clinician, Behavioral Health

This is a fully remote position, open to applicants in Idaho, +2 more states.

📋 Description

• Assess preauthorization requests for behavioral health services utilizing evidence-based guidelines and clinical judgment.

• Coordinate, document, and convey utilization management decisions to providers and stakeholders.

• Handle crisis calls, evaluate risk, identify support needs, and coordinate suitable interventions.

• Elevate concerns regarding suicide risk, self-harm, and welfare checks as necessary.

• Leverage clinical expertise to promote quality, cost-effective care and positive outcomes for members.

• Operate in a dynamic, queue-based environment while juggling multiple priorities.

• Collaborate with providers and care teams to ensure appropriate levels of care are maintained.

⛳️ Requirements

• A current, unrestricted independent behavioral health clinical license in the state of residence, such as LCSW, LICSW, LISW, LMSW, LPC, LMHC, LCMHC, LMFT, Clinical Psychologist, or RN.

• Over 3 years of post-licensure experience in behavioral health.

• More than 3 years of experience working in the field of mental health and substance use disorders.

• Proficient in simultaneously managing telephonic and computer-based tasks.

• High-speed residential internet service with a minimum of 25 Mbps download and 3 Mbps upload speeds.

• Availability for the specified Thursday-Friday and Saturday-Sunday night shift schedule.

• Willingness to work on holidays.

• Preferred experience in hospital-based behavioral health settings.

• Preferred experience in Utilization Management or Prior Authorization.

• Preferred experience in Managed Care.

• For Behavioral Health Clinicians: Master’s degree in Social Work, Counseling, or Psychology.

• For Registered Nurses: Bachelor’s degree in Nursing with a focus on Behavioral Health or Psychology.

🏝️ Benefits

• 10% shift differential.

• Fully remote position available anywhere in the U.S.

• Opportunity to apply clinical expertise in a non-traditional environment.

• Engaging work that enhances access to quality behavioral health care.

• Collaborative, mission-driven team atmosphere.

• Medical coverage.

• Dental coverage.

• Vision coverage.

• Paid time off.

• Retirement savings options.

• Wellness programs.

• Additional resources supporting the physical, emotional, and financial well-being of colleagues and their families.

• CVS Health bonus, commission, or short-term incentive program in addition to the base pay range.