Behavioral Health UM Clinician I — Care Coordination

Community Health Plan of Washington; Olympia (WA); On-site; USD 70,000 - 100,000; Full time

Job summary

Community Health Plan of Washington is seeking a Level I Utilization Management Clinician to perform utilization review for medical or behavioral health requests, ensuring timely access to care and collaboration with the health care team. The role emphasizes coordinating with facilities, patients, and family, supporting transitions, and upholding CHPW policies and procedures.

Requirements include a bachelor’s degree in a relevant field, an active RN or LPN license, and at least two years of

Qualifications

• Bachelor’s degree in a relevant field or equivalent experience.
• Current, unrestricted RN or LPN license.
• At least two years of clinical experience in physical or behavioral health.
• Prior Utilization Management/Managed Care experience preferred.

Responsibilities

• Review hospital notifications and prior authorization against clinical guidelines.
• Collaborate with facilities for discharge planning.
• Support member transitions between care settings and back home after hospitalization.
• Coordinate with care teams to ensure timely, appropriate care within regulatory timeframes.
• Identify and communicate care gaps and alternatives to optimize patient outcomes.

Skills

Communication skills

Independent work

Analytical skills

Detail oriented

Education

Bachelor's degree in a relevant field

Job description

Community Health Plan of Washington is seeking a Level I Utilization Management Clinician to perform utilization review for medical or behavioral health requests, ensuring timely access to care and collaboration with the health care team. The role emphasizes coordinating with facilities, patients, and family, supporting transitions, and upholding CHPW policies and procedures.

Requirements include a bachelor’s degree in a relevant field, an active RN or LPN license, and at least two years of