Remote Behavioral Health Utilization Clinician

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

Benefits offered by this job

Remote work options

Health benefits

401(k) with company match

Job summary

Cambia Health is seeking a Behavioral Health Utilization Management Clinician to join its health services team. This remote role supports members across Oregon, Washington, Idaho, or Utah, focusing on prospective, concurrent, and retrospective reviews to promote medical necessity and cost-effective care.

Candidates hold a Master's in Behavioral Health, license in one of WA/OR/ID/UT, and have 3 years of utilization management or clinical experience.

Qualifications

• Master's degree in Behavioral Health or closely related field.
• 3 years of utilization management or behavioral health care management experience.
• 3 years direct Behavioral Health clinical experience as an independently licensed Master’s level clinician.

Responsibilities

• Performs prospective, concurrent, and retrospective utilization reviews.
• Applies clinical expertise and evidence-based criteria to make determinations.
• Collaborates with interdisciplinary teams to facilitate transitions of care.
• Provides prompt responses to internal/external inquiries with strong customer service.
• Identifies opportunities for quality improvement and participates in initiatives.
• Maintains meticulous documentation to meet performance standards.
• Upholds confidentiality and communicates professionally with stakeholders.

Skills

Behavioral health experience

Policy interpretation

Computer skills

EHR familiarity

Interpersonal communication

Time management

Critical thinking

Education

Master's degree in Behavioral Health

Tools

Microsoft Office

Outlook

EHR systems

Job description

Cambia Health is seeking a Behavioral Health Utilization Management Clinician to join its health services team. This remote role supports members across Oregon, Washington, Idaho, or Utah, focusing on prospective, concurrent, and retrospective reviews to promote medical necessity and cost-effective care.

Candidates hold a Master's in Behavioral Health, license in one of WA/OR/ID/UT, and have 3 years of utilization management or clinical experience.