Remote Behavioral Health Utilization Clinician

Cambia Health; Olympia (WA); Remote; USD 48,000 - 79,000; Full time

Benefits offered by this job

Work from home options

Competitive benefits

Job summary

Cambia Health is seeking a Behavioral Health Utilization Management Clinician to conduct prospective, concurrent, and retrospective reviews ensuring medical necessity and policy alignment. This role emphasizes evidence-based decision-making and collaboration with physician advisors.

Candidates must hold an unrestricted license in WA/OR/ID/UT and be willing to obtain licensure in multiple states, with remote work options available across designated states and regionally structured pay.

Qualifications

• Master's degree in behavioral health discipline.
• 3 years of utilization management or behavioral health care management experience.
• Licensed in WA/OR/ID/UT or eligible to be licensed in multiple states.

Responsibilities

• Perform comprehensive utilization management reviews (prospective, concurrent, retrospective).
• Apply clinical criteria to determine medical necessity and policy adherence.
• Collaborate with interdisciplinary teams to coordinate transitions of care.

Skills

Utilization management

Clinical communication

Time management

Interdisciplinary collaboration

Education

Master's Degree in Behavioral Health

State clinical license

Job description

Cambia Health is seeking a Behavioral Health Utilization Management Clinician to conduct prospective, concurrent, and retrospective reviews ensuring medical necessity and policy alignment. This role emphasizes evidence-based decision-making and collaboration with physician advisors.

Candidates must hold an unrestricted license in WA/OR/ID/UT and be willing to obtain licensure in multiple states, with remote work options available across designated states and regionally structured pay.