Remote Behavioral Health Utilization Clinician

Cambia Health; Bend (OR); Remote; USD 51,000 - 69,000; Full time

Benefits offered by this job

Work from home options

Competitive benefits

401(k) with company match

Parental leave

Wellness programs

Job summary

Cambia Health is seeking a Behavioral Health Utilization Management Clinician. This remote role supports Oregon, Washington, Idaho, or Utah with a focus on medical necessity decisions and care optimization.

You will review utilization across prospective, concurrent, and retrospective cases and collaborate with physicians and care teams. Ideal candidates hold a Master's in Behavioral Health, 3+ years in UM/BI care management, and an unrestricted license in any listed state, with multi-state

Qualifications

• Master's degree in behavioral health discipline with current license.
• 3 years utilization management or behavioral health care management experience.
• Licensed or eligible in WA, OR, ID, or UT and willing to be licensed in multiple states.

Responsibilities

• Perform comprehensive utilization management reviews: prospective, concurrent, retrospective.
• Apply clinical criteria to determine medical necessity and policy conformity.
• Collaborate with interdisciplinary teams to facilitate transitions of care.
• Provide prompt, accurate responses to inquiries with strong customer service.
• Identify improvement opportunities and participate in quality initiatives.
• Maintain meticulous documentation to meet performance standards.
• Protect confidentiality and communicate professionally with stakeholders.

Skills

Utilization management expertise

Behavioral health care management

Interdisciplinary collaboration

Documentation skills

Education

Master's Degree in Behavioral Health Discipline

Tools

Electronic health records

Microsoft Office / Outlook

Job description

Cambia Health is seeking a Behavioral Health Utilization Management Clinician. This remote role supports Oregon, Washington, Idaho, or Utah with a focus on medical necessity decisions and care optimization.

You will review utilization across prospective, concurrent, and retrospective cases and collaborate with physicians and care teams. Ideal candidates hold a Master's in Behavioral Health, 3+ years in UM/BI care management, and an unrestricted license in any listed state, with multi-state