Licensed Remote Behavioral Health Utilization Clinician

Cambia Health Solutions; Pocatello (ID); Remote; USD 43,000 - 71,000; Full time

Benefits offered by this job

Remote work options

Competitive benefits

401(k) with company match

Job summary

Cambia Health Solutions seeks licensed behavioral health clinicians for utilization management roles. You will review medical necessity across prospective, concurrent, and retrospective processes, applying evidence-based criteria and consulting physician advisors as needed.

Work-from-home options are available across Oregon, Washington, Idaho, and Utah, with Idaho/Utah preference for current residents. The role emphasizes collaboration with care teams and patient-focused outcomes.

Qualifications

• Master’s Degree in Behavioral Health required.
• 3 years of utilization management or behavioral health care management experience.
• 3 years of direct Behavioral Health clinical experience as an independently licensed clinician.
• Unrestricted license in WA, OR, ID or UT; willing to be licensed in multiple states.

Responsibilities

• Perform comprehensive utilization management reviews (prospective, concurrent, retrospective).
• Apply clinical expertise and evidence-based criteria; consult physician advisors as needed.
• Collaborate with interdisciplinary teams to ensure care transitions.
• Provide prompt, accurate responses to inquiries with strong customer service.
• Identify opportunities for improvement and participate in quality initiatives.
• Maintain meticulous documentation and meet performance standards.
• Protect confidentiality and communicate professionally with stakeholders.

Skills

Utilization management

Clinical communication

Interdisciplinary collaboration

Time management

Policy interpretation

Education

Master’s Degree in Behavioral Health

Behavioral health licensure

Tools

Microsoft Office

Outlook

EHR systems

Job description

Cambia Health Solutions seeks licensed behavioral health clinicians for utilization management roles. You will review medical necessity across prospective, concurrent, and retrospective processes, applying evidence-based criteria and consulting physician advisors as needed.

Work-from-home options are available across Oregon, Washington, Idaho, and Utah, with Idaho/Utah preference for current residents. The role emphasizes collaboration with care teams and patient-focused outcomes.