Clinical Utilization & Care Coordinator

EMC Behavioral Health; Houston (TX); Hybrid; USD 70,000 - 90,000; Full time

Benefits offered by this job

Group Health insurance options

Paid Time Off

Retirement Savings

Job summary

EMC Behavioral Health is seeking a Utilization Specialist to drive clinical excellence in a hybrid outpatient setting in Houston. You will coordinate care, perform assessments, and manage utilization reviews for diverse clients while collaborating with families and interdisciplinary teams.

The role emphasizes documentation, regulatory compliance, and ongoing quality improvement with potential contract-to-hire conversion and full-time benefits.

Qualifications

• Bachelor's degree or higher in a relevant field; QMHP certification and HIPAA training preferred.
• CANS/ANSA certification or willingness to obtain it.
• 1+ year in behavioral health, case management, or UM-related role; 2–3 years preferred.

Responsibilities

• Coordinate appointments, therapy sessions, referrals, and supportive services.
• Monitor client progress, medication adherence, and engagement in programming.
• Partner with families, caregivers, and interdisciplinary teams to ensure continuity of care.
• Conduct initial and ongoing assessments and support individualized recovery plans.
• Lead prior authorizations, concurrent reviews, and discharge planning.
• Ensure compliance with Medicaid/Medicare, payer guidelines, and regulatory requirements.
• Prepare monthly utilization and outcomes reports; participate in UM meetings.

Skills

Strong communication

Documentation

Assessment & planning

Collaboration across teams

Education

Bachelor's degree in psychology, sociology, criminal justice, education or related field

Master's degree preferred

Job description

EMC Behavioral Health is seeking a Utilization Specialist to drive clinical excellence in a hybrid outpatient setting in Houston. You will coordinate care, perform assessments, and manage utilization reviews for diverse clients while collaborating with families and interdisciplinary teams.

The role emphasizes documentation, regulatory compliance, and ongoing quality improvement with potential contract-to-hire conversion and full-time benefits.