Remote Behavioral Health UM Clinician

Cambia Health Solutions; Washington; Remote; USD 44,000 - 70,000; Full time

Benefits offered by this job

Medical, dental and vision coverage

Paid time off and holidays

401(k) with company match

Remote work options

Job summary

Cambia Health Solutions is seeking a licensed Behavioral Health clinician to manage utilization reviews across prospective, concurrent, and retrospective assessments. The role emphasizes applying evidence-based criteria and collaborating with physician advisors to ensure appropriate care and payment decisions.

Candidates should have a Master’s in Behavioral Health and at least 3 years of utilization management or care management experience, plus eligibility for multi-state licensure (WA, OR, ID,

Qualifications

• Master’s degree in Behavioral Health required.
• 3 years of utilization management or behavioral health care management experience.
• Unrestricted clinical license in WA/OR/ID/UT or eligible for multi-state licensure.

Responsibilities

• Perform utilization management reviews (prospective, concurrent, retrospective) to ensure medical necessity.
• Apply clinical criteria and consult with physician advisors to determine appropriate decisions.
• Collaborate with interdisciplinary teams to coordinate transitions of care and resolve issues promptly.
• Provide timely, accurate responses to inquiries with strong customer service focus.
• Identify improvement opportunities and contribute to quality improvement initiatives.
• Maintain meticulous documentation to meet performance standards.
• Protect confidentiality and interact professionally with members, providers, and regulators.

Skills

Utilization management experience

Licensed clinician

Multistate licensure (WA, OR, ID, UT)

Education

Master’s Degree in Behavioral Health

Tools

Microsoft Office

Electronic health records

Job description

Cambia Health Solutions is seeking a licensed Behavioral Health clinician to manage utilization reviews across prospective, concurrent, and retrospective assessments. The role emphasizes applying evidence-based criteria and collaborating with physician advisors to ensure appropriate care and payment decisions.

Candidates should have a Master’s in Behavioral Health and at least 3 years of utilization management or care management experience, plus eligibility for multi-state licensure (WA, OR, ID,