Utilization Management Clinician, Behavioral Health – Autism Care Team

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

📋 Description

• Evaluate the suitability of treatment plans for ABA services using evidence-based standards and practice guidelines.

• Organize, oversee, and assess healthcare services and benefit options available for members.

• Provide triage and crisis support as needed.

• Collect clinical information and utilize clinical criteria, guidelines, policies, and procedures to make coverage determinations and recommendations.

• Ensure effective discharge planning throughout the continuum of care.

• Collaborate with providers and other stakeholders to ensure optimal care and treatment.

• Identify members at risk for adverse outcomes and assist in referrals to additional products, services, and programs.

• Conduct outreach to members to offer resources, education, answer inquiries, and provide referrals.

• Recognize opportunities to enhance quality and effective utilization of healthcare services and benefits.

• Advise internal and external stakeholders on utilization and benefits management.

⛳️ Requirements

• A valid, unrestricted independent professional behavioral health clinical license to practice in the state of residence; one or more of the following is required: LPC, LMFT, LCSW, LCPC, LMHC, LCMHC, LICSW, LISW, LBS, LBA, or Clinical Psychologist, or an equivalent license.

• A minimum of 3 years of direct clinical practice experience following a master’s degree.

• At least 2 years of experience in crisis intervention.

• A minimum of 3 years of experience working with clients diagnosed with autism.

• Access to residential broadband service with internet speeds of no less than 25 mbps/3 mbps.

• A master’s degree in Behavioral/Mental Health or Human Service/Health Services.

• Previous experience in Managed Care is preferred.

🏝️ Benefits

• Comprehensive benefits package for full-time employees.

• Medical insurance coverage.

• Dental insurance coverage.

• Vision insurance coverage.

• Paid time off for personal and vacation days.

• Retirement savings options available.

• Wellness programs to promote health and well-being.

• Additional resources based on eligibility.

• Possible partial reimbursement for residential broadband service expenses.

• CVS Health bonus, commission, or short-term incentive program available in addition to base salary.