Remote Behavioral Health Utilization Clinician

Cambia Health Solutions; Oregon; Remote; USD 73,000 - 105,000; Full time

Benefits offered by this job

Medical, dental and vision coverage

Generous paid time off

Retirement plan with company match

Wellness programs

Job summary

Cambia Health Solutions is seeking licensed Behavioral Health Clinicians to perform utilization management reviews across prospective, concurrent, and retrospective assessments. The role emphasizes high-quality care, collaboration with physician advisors, and strong documentation practices.

The position supports work-from-home options within Oregon, Washington, Idaho, or Utah, with compensation tied to licensure, experience, and regional pay structures.

Qualifications

• Master’s degree in a behavioral health discipline required.
• 3 years of utilization management or behavioral health care management experience.
• Licensed independently in WA, OR, ID or UT and eligible for multi-state licensure.

Responsibilities

• Perform comprehensive utilization management reviews (prospective, concurrent, retrospective) to ensure medical necessity and policy adherence.
• Apply clinical criteria and consult with physician advisors as needed to ensure accuracy.
• Collaborate with interdisciplinary teams to facilitate transitions of care and issue resolution.
• Provide prompt, accurate responses to inquiries while maintaining exceptional customer service.
• Identify opportunities for quality improvement and participate in initiatives.
• Maintain meticulous documentation to meet performance standards and protect confidentiality.

Skills

Behavioral health knowledge

Utilization management

Clinical licensure

Multi-state licensure readiness

Education

Master's degree in Behavioral Health

Tools

Microsoft Office

Outlook

EHR systems

Job description

Cambia Health Solutions is seeking licensed Behavioral Health Clinicians to perform utilization management reviews across prospective, concurrent, and retrospective assessments. The role emphasizes high-quality care, collaboration with physician advisors, and strong documentation practices.

The position supports work-from-home options within Oregon, Washington, Idaho, or Utah, with compensation tied to licensure, experience, and regional pay structures.