Remote Behavioral Health Utilization Clinician

Cambia Health Solutions; United States; Remote; USD 70,000 - 115,000; Full time

Benefits offered by this job

Remote work options

Competitive benefits

401(k) with company match

Job summary

Cambia Health Solutions is seeking a Behavioral Health Utilization Management Clinician to perform prospective, concurrent and retrospective reviews across; offer expert clinical judgment to ensure medical necessity and cost-effective care. This role supports members through collaboration with interdisciplinary teams and provides timely, accurate responses to inquiries.

Ideal candidates hold a Master’s in behavioral health, licensure in WA, OR, ID or UT, and at least three years of utilization

Qualifications

• Master's degree in behavioral health discipline.
• 3 years of utilization management or behavioral health care management experience.
• Clinical license unrestricted and current in state of residence; WA/OR/ID/UT license and multi-state willingness.

Responsibilities

• Performs comprehensive utilization management reviews (prospective, concurrent, retrospective).
• Applies clinical expertise and criteria to determine medical necessity and policy adherence.
• Collaborates with interdisciplinary teams to facilitate transitions of care and resolve issues.

Skills

Utilization management

Behavioral health care management

Clinical communication

Interdisciplinary collaboration

Education

Master's Degree in Behavioral Health Discipline

Tools

Microsoft Office

EHR systems

Job description

Cambia Health Solutions is seeking a Behavioral Health Utilization Management Clinician to perform prospective, concurrent and retrospective reviews across; offer expert clinical judgment to ensure medical necessity and cost-effective care. This role supports members through collaboration with interdisciplinary teams and provides timely, accurate responses to inquiries.

Ideal candidates hold a Master’s in behavioral health, licensure in WA, OR, ID or UT, and at least three years of utilization