Remote Behavioral Health Utilization Clinician

Cambia Health Solutions; Tacoma (WA); Remote; USD 73,000 - 119,000; Full time

Benefits offered by this job

Medical, dental and vision coverage

Paid time off and holidays

401(k) with company match

Parental leave 12 weeks

Wellness programs

Employee Assistance Fund

Commuter benefits

Job summary

Cambia Health Solutions is seeking a licensed Behavioral Health Clinician to perform utilization management across prospective, concurrent, and retrospective reviews. The role emphasizes collaboration with physician advisors and interdisciplinary teams to ensure medical necessity and cost-effective outcomes.

The position supports remote work options within OR, WA, ID, UT, with pay structures tied to regional markets and a bonus target. Licensure in multiple states is encouraged.

Qualifications

• Master’s degree in Behavioral Health required and active clinical license.
• Experience in utilization management or behavioral health care management.
• Licensed in WA/OR/ID/UT or eligible for multi-state licensing.

Responsibilities

• Perform comprehensive utilization management reviews (prospective, concurrent, retrospective).
• Apply clinical criteria and consult physicians to ensure medical necessity.
• Collaborate with care teams to facilitate transitions and address issues.
• Provide timely, accurate responses to inquiries and maintain service quality.
• Identify improvement opportunities and participate in quality initiatives.
• Maintain thorough documentation and protect patient confidentiality.

Skills

Advanced behavioral health settings

Health insurance trends

Microsoft Office

Outlook

EMR/documentation systems

Communication skills

Policy interpretation

Time management

Critical thinking

Education

Master’s Degree in Behavioral Health

Unrestricted clinical license in WA/OR/ID/UT

Tools

Microsoft Office

Outlook

EMR systems

Job description

Cambia Health Solutions is seeking a licensed Behavioral Health Clinician to perform utilization management across prospective, concurrent, and retrospective reviews. The role emphasizes collaboration with physician advisors and interdisciplinary teams to ensure medical necessity and cost-effective outcomes.

The position supports remote work options within OR, WA, ID, UT, with pay structures tied to regional markets and a bonus target. Licensure in multiple states is encouraged.