Remote Behavioral Health Utilization Clinician

Cambia Health Solutions; Medford (OR); Remote; USD 48,000 - 79,000; Full time

Benefits offered by this job

Medical, dental, vision coverage

Health Savings Account

Paid time off

Job summary

Cambia Health Solutions is looking for a licensed Behavioral Health Clinician to lead utilization management efforts from a remote location serving Oregon, Washington, Idaho or Utah. You will review medical necessity decisions, collaborate with physicians, and support case management to improve outcomes and cost-effectiveness.

The role requires a Master’s degree in Behavioral Health, unrestricted clinical licensure, and 3 years of related experience.

Qualifications

• Master’s degree in a behavioral health discipline.
• 3 years of utilization management or behavioral health care management experience.
• Licensed in WA, OR, ID or UT with ability to be licensed in multiple states.
• Independently licensed Master's level Behavioral Health Clinician in psychology, counseling, social work, or related field.

Responsibilities

• Perform comprehensive utilization management reviews (prospective, concurrent, retrospective).
• Apply clinical expertise and evidence-based criteria; consult with physician advisors as needed.
• Collaborate with interdisciplinary teams to facilitate transitions of care and resolve issues.
• Provide prompt, accurate responses to inquiries and ensure excellent customer service.
• Identify opportunities for quality improvement and participate in initiatives.
• Maintain meticulous documentation and uphold data confidentiality.
• Communicate professionally with members, providers and regulators.

Skills

Utilization management

Licensed clinician

Interstate licensing

Education

Master's degree in Behavioral Health

Tools

Microsoft Office

Outlook

Job description

Cambia Health Solutions is looking for a licensed Behavioral Health Clinician to lead utilization management efforts from a remote location serving Oregon, Washington, Idaho or Utah. You will review medical necessity decisions, collaborate with physicians, and support case management to improve outcomes and cost-effectiveness.

The role requires a Master’s degree in Behavioral Health, unrestricted clinical licensure, and 3 years of related experience.