Licensed Behavioral Health Professional

Randstad USA; Wallingford (CT); On-site; USD 51,000 - 55,000; Full time

Job summary

Randstad USA in Arizona seeks an Utilization Management Clinical Consultant (UMCC) to apply clinical expertise and evidence-based criteria to assess medical necessity and quality of behavioral health services for adults and children.

The role supports utilization of benefits across the care continuum through collaboration, clinical review, stakeholder communication, and timely authorization decisions.

Qualifications

• Must have an active Arizona LCSW, LPC, or LMFT.
• Experience performing behavioral health utilization management or clinical reviews.

Responsibilities

• Review clinical information and apply medical necessity criteria to render coverage determinations.
• Analyze medical records to ensure services align with evidence-based standards and quality benchmarks.
• Coordinate with healthcare providers, internal teams, and external stakeholders to facilitate timely, appropriate care and authorization decisions.
• Conduct concurrent reviews to monitor ongoing inpatient or outpatient treatment and support continuity of care.
• Identify members who may benefit from care management programs and facilitate appropriate referrals.
• Provide urgent or emergent clinical interventions when required, including triage and crisis support.
• Identify opportunities to optimize resource utilization, reduce unnecessary services, and promote cost-effective, high-quality care.
• Educate providers, under appropriate supervision, on utilization management processes, documentation requirements, and applicable guidelines.
• Develop and support initiatives that enhance quality effectiveness and benefit utilization.
• Prepare clinical reports and documentation to communicate findings, monitor KPIs, and track utilization management outcomes.

Skills

Behavioral Health Utilization Mgmt

Clinical Assessment & Critical Think

Communication & Coordination

Education

Bachelor's degree

Job description

job summary:

The Utilization Management Clinical Consultant (UMCC) applies clinical expertise and evidence-based criteria to assess the medical necessity, appropriateness, and quality of behavioral health services for adult and child/adolescent members. This role supports appropriate utilization of benefits across the continuum of care through collaboration, clinical review, and stakeholder communication.

location: Arizona

job type: Contract

salary: $37- $39.83 per hour

work hours: M-F 8am-5pm AZ time

education: Bachelors degree

responsibilities:

• Review clinical information and apply medical necessity criteria, clinical guidelines, policies, and professional judgment to render coverage determinations and discharge planning decisions.
• Analyze medical records and clinical data to ensure services align with evidence-based standards and quality benchmarks.
• Coordinate and communicate with healthcare providers, internal teams, and external stakeholders to facilitate timely, appropriate care and authorization decisions.
• Conduct concurrent reviews to monitor ongoing inpatient or outpatient treatment and support continuity of care.
• Identify members who may benefit from care management programs and facilitate appropriate referrals.
• Provide urgent or emergent clinical interventions when required, including triage and crisis support.
• Identify opportunities to optimize resource utilization, reduce unnecessary services, and promote cost-effective, high-quality care.
• Educate providers, under appropriate supervision, on utilization management processes, documentation requirements, and applicable guidelines.
• Develop and support initiatives that enhance quality effectiveness and benefit utilization.
• Prepare clinical reports and documentation to communicate findings, monitor key performance indicators, and track utilization management outcomes.

qualifications

• MUST HAVE AN ACTIVE ARIZONA (LCSW — Licensed Clinical Social Worker OR LPC — Licensed Professional Counselor OR LMFT — Licensed Marriage and Family Therapist)
• Experience performing behavioral health utilization management or clinical reviews

skills

• Behavioral Health Utilization Management: Ability to review clinical information, apply medical necessity guidelines, and make UM decisions (initial, concurrent, and discharge planning). Includes strong discharge planning skills to support safe, appropriate transitions of care.
• Clinical Assessment & Critical Thinking - Skilled in evaluating clinical needs, reviewing records, and making sound decisions that balance quality, cost, and member-centered care. Must have a strong understanding of community behavioral health resources to support referrals and continuity of care.
• Communication & Coordination - Strong communication skills with providers and internal teams, plus accurate documentation and strong organizational skills. Ability to coordinate effectively across multiple stakeholders to support timely care and utilization decisions.

Equal Opportunity Employer: Race, Color, Religion, Sex, Sexual Orientation, Gender Identity, National Origin, Age, Genetic Information, Disability, Protected Veteran Status, or any other legally protected group status.

At Randstad, we welcome people of all abilities and want to ensure that our hiring and interview process meets the needs of all applicants. If you require a reasonable accommodation to make your application or interview experience a great one, please contact [e-mail].

Pay offered to a successful candidate will be based on several factors including the candidate's education, work experience, work location, specific job duties, certifications, etc.

In addition, Randstad offers a comprehensive benefits package, including: medical, prescription, dental, vision, AD&D, and life insurance offerings, short-term disability, and a 401K plan (all benefits are based on eligibility).

• medical
• prescription
• dental
• vision
• AD&D
• life insurance offerings
• short-term disability
• a 401K plan

This posting is open for thirty (30) days.