Clinician, Utilization Management

Lucet; United States; Remote; USD 72,000 - 77,000; Full time

Benefits offered by this job

Comprehensive health benefits

401(k) plan with employer match

Life and disability insurance

Paid parental leave

Generous PTO including volunteer time

Flexible spending accounts

Tuition reimbursement

Remote work flexibility

Professional development opportunities

Job summary

Lucet is seeking a Utilization Management Clinician to review and authorize requests, coordinating behavioral health care with our provider network. You will determine medical necessity, support appropriate discharge planning, and ensure exceptional member service.

This remote, home-based role requires a state license, at least two years of direct clinical care in psychiatric or chemical dependency settings, strong communication, and ability to interpret medical policy.

Qualifications

• Has a current, unrestricted license to practice independently as a licensed clinician in the United States.
• Minimum of two years of direct clinical care experience in psychiatric or chemical dependency treatment.
• Excellent verbal and written communication and interpersonal skills.
• Ability to comprehend medical policy and criteria and articulate health information clearly.
• Must be able to pass comprehensive background checks and safety screenings.

Responsibilities

• Utilization Management & Clinical Review: conduct behavioral health utilization reviews and apply medical necessity criteria.
• Care Coordination & Member Support: coordinate care with families, providers, and clients to access services and support discharge planning.
• Compliance, Systems & Professional Development: maintain documentation, use clinical systems, and adhere to policies.

Skills

Clinical communication

Documentation skills

Medical policy understanding

Background check readiness

Education

Clinical licensure (SW/LMFT/LCPC/PSY/RN)

Job description

Who We Are

At Lucet, we're transforming whole-person care. We deliver integrated behavioral and physical health solutions that connect individuals to the right care at the right time - improving outcomes and overall well-being. Serving over 15 million lives across the U.S. and Puerto Rico, our model combines clinical expertise, compassionate care, and innovative technology to support healthier, more fulfilling lives.

As part of the Lucet team, employees join a mission-driven organization committed to making a lasting impact. Whether through behavioral health navigation, in-home medical care, or 24/7 crisis support, our work is rooted in empathy, collaboration, and a shared passion for helping people thrive.

Who We Are

At Lucet, we're transforming whole-person care. We deliver integrated behavioral and physical health solutions that connect individuals to the right care at the right time - improving outcomes and overall well-being. Serving over 15 million lives across the U.S. and Puerto Rico, our model combines clinical expertise, compassionate care, and innovative technology to support healthier, more fulfilling lives.

As part of the Lucet team, employees join a mission-driven organization committed to making a lasting impact. Whether through behavioral health navigation, in-home medical care, or 24/7 crisis support, our work is rooted in empathy, collaboration, and a shared passion for helping people thrive.

Why Join our Team

At Lucet, we're committed to creating a workplace where top talent thrives both personally and professionally. We offer a dynamic, mission-driven environment where your work has real impact, your unique background and experience are valued, and no two days are alike. If you're passionate about meaningful work and delivering impactful results, we encourage you to apply!

We support our team with a competitive compensation and benefits package, including:

• Annual compensation between $72,000-$77,000, PLUS an annual performance-based, discretionary incentive.
  • *Compensation is dependent on non-discriminatory factors including but not limited to an applicant's skills, education/degrees, certifications, prior experience, market data, and other relevant factors.
• Comprehensive health benefit options: Medical, dental, and vision coverage
• 401(k) with competitive employer match
• Company-paid life and disability insurance
• Paid parental leave and wellbeing incentives
• Generous paid time off, including volunteer time
• Flexible spending accounts for healthcare and dependent care
• Professional development opportunities and tuition reimbursement
• Remote work flexibility (role-dependent)
• Opportunity for meaningful growth, both personally and professionally, where your unique background and experience is welcomed and valued.

At Lucet, your work will directly support our mission to improve behavioral, physical, and social health - one member at a time.

What You Will Do - Essential Functions

The Utilization Management Clinician is responsible for reviewing and completing initial and concurrent authorization requests, ensuring excellent customer service and member care. The role includes behavioral health clinical care coordination with the daily handling of incoming telephonic contact from our provider network, with the intent of making medical necessity determinations and ensuring appropriate discharge planning.

• Utilization Management & Clinical Review
  • Conducts comprehensive behavioral health utilization reviews, applying medical necessity criteria, clinical judgment, and evidence-based practices to support appropriate level-of-care determinations and member outcomes.
• Care Coordination & Member Support
  • Collaborates with members, families, providers, and clients to coordinate care, facilitate access to behavioral health services, support discharge planning, and promote successful treatment outcomes.
• Compliance, Systems & Professional Development
  • Maintains compliance with regulatory and accreditation standards through accurate documentation, effective use of clinical systems, ongoing professional development, and adherence to organizational policies and procedures.

Who You Are

• Required Qualifications
  • Has a current, unrestricted license issued by a state or territory of the United States to practice independently as a clinical social worker, marriage and family therapist, professional counselor, clinical psychologist, or registered nurse in the state in which the business operation is located and/or other states as required by law, regulation, or contract.
  • Minimum of two years of direct clinical care experience with patients in facility based and/or outpatient psychiatric or chemical dependency treatment.
  • Excellent verbal and written communication and interpersonal skills, strong computer and keyboarding skills including the ability to document while simultaneously taking information over the phone.
  • Ability to comprehend medical policy and criteria to clearly articulate health information.
  • Ability to pass background check upon hire and throughout employment to include criminal felony & misdemeanor search, SSN validation/trace search (LEIE), education report (highest degree obtained), civil upper and lower search, 7-year employment report, federal criminal search, statewide criminal search, widescreen plus national criminal search, health care sanctions-state med (SAM), national sex offender registry, prohibited parties (OFAC) (terrorist watchlist), and a 10-Panel Drug Screen.

Living Our Values

• Serving everyone with compassion and leading with empathy.
• Stepping up and creating value by taking charge and acting when there is an opportunity.
• Adapting in a changing world by recognizing our responsibility to be agile and respond quickly.
• Nurturing growth and belonging by respecting and celebrating everyone for who they are.

Competencies

• Self-motivated with excellent organizational skills.
• Ability to multitask and manage multiple priorities in a fast-paced, changing environment.
• Ability to work independently to meet caseload requirements and team objectives/goals.
• Ability to work within a collaborative, team-oriented environment.
• Ability to remain resilient and optimistic in the face of problems and challenges.

Working Conditions

• High-speed internet service (cable or fiber optic) with minimum download Speed of 20 Mbps, Upload Speed of 5 Mbps, and Maximum Latency of 100 milliseconds (must be installed before starting) required.
• Frequent use of computer and phone systems
• Must be able to constantly remain in a stationary, sitting position, communicate and exchange information with others, inspect information, perform repetitive motions with arms and fingers, interpret data, problem solve, make decisions, organize and plan, and maintain a positive and professional attitude in all situations.
• Work is performed from home with company-provided equipment. Sitting for long periods of time is expected and use of fingers and hands for typing is necessary.
• A quiet workspace with minimal background noise for calls.
• This role requires working from a fixed, designated workspace in your home and does not allow flexibility in work locations even within the home.
• A hardwired internet connection is required along with ability to sit for extended periods using company-issued wired headsets and desktop equipment.

We encourage applicants from a variety of backgrounds and experiences to apply, especially those who can demonstrate how their unique qualifications and skills align with the requirements of this role and support our mission to improve whole-person health.

This position will accept and review new applications and resumes no less than 5 business days after the original posting date and may remain open an extended period of time with no set end date based on the level of interest.