Remote Behavioral Health Utilization Clinician

Comagine.org; Oregon; Remote; USD 90,000 - 120,000; Full time

Benefits offered by this job

Medical, dental and vision insurance

Paid time off for vacation and illness

Retirement savings plan with employer

Adoption financial assistance

Paid parental leave

Job summary

Comagine Health is seeking a utilization review clinician to assess medical necessity for behavioral health services. You will review documentation, apply evidence-based criteria, and document determinations in the EMR, supporting care decisions and care coordination across children, youth, and adults.

The role is 100% remote with travel across Eugene and surrounding areas in Oregon. Requires licensure in Oregon and at least 3 years of direct behavioral health experience, with strong clinical

Qualifications

• Active, unrestricted clinical licensure in Oregon (LCSW/LPC/LCPC or equivalent).
• At least 3 years of direct clinical experience in behavioral health.
• Residence in Oregon with ability to travel; valid driver’s license.
• Experience with utilization review or medical management preferred.
• Knowledge of Oregon behavioral health system of care is a plus.

Responsibilities

• Review clinical docs to determine medical necessity and appropriateness for services.
• Perform initial and continued stay reviews using evidence-based criteria.
• Document determinations in EMR accurately and timely.
• Consult with clinicians when cases do not meet criteria.
• Support quality audits and program activities.
• Travel for in-person assessments within assigned region.

Skills

Clinical judgment

Utilization review

Communication skills

Organizational skills

Interpersonal skills

Team collaboration

Problem-solving

Attention to detail

Education

Licensed clinician in Oregon (LCSW/LPC/LCPC)

Tools

MS Office Suite

EMR systems

InterQual criteria

Oregon Health Plan Prioritized List

Job description

Comagine Health is seeking a utilization review clinician to assess medical necessity for behavioral health services. You will review documentation, apply evidence-based criteria, and document determinations in the EMR, supporting care decisions and care coordination across children, youth, and adults.

The role is 100% remote with travel across Eugene and surrounding areas in Oregon. Requires licensure in Oregon and at least 3 years of direct behavioral health experience, with strong clinical