Remote Behavioral Health Utilization Clinician

Cambia Health Solutions, Inc.; Utah; Remote; USD 51,000 - 69,000; Full time

Benefits offered by this job

Medical, dental and vision coverage

Annual health savings account (HSA)

Paid time off + 10 company holidays

401(k) retirement plan with company 
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Up to 12 weeks parental leave

Job summary

Cambia Health Solutions, Inc. is seeking a Behavioral Health Utilization Management Clinician to work from home within Oregon, Washington, Idaho or Utah.

You’ll perform prospective, concurrent and retrospective reviews to support medically necessary care while promoting cost-effective outcomes. The role requires a licensed clinician with a master’s in behavioral health and experience in utilization management, using Microsoft Office tools and electronic health records.

Qualifications

• Master’s Degree in Behavioral Health Discipline is required.
• Licensed Clinician status is expected.
• Proficiency in Microsoft Office, Outlook and internet search.

Responsibilities

• Perform comprehensive utilization management reviews (prospective, concurrent, retrospective).
• Apply clinical expertise and evidence-based criteria for determinations with physician consults as needed.
• Respond to internal/external inquiries promptly with accurate information.
• Identify opportunities for quality improvement and participate in initiatives.
• Maintain meticulous documentation to meet performance standards and privacy obligations.

Skills

Verbal communication

Written communication

Interpersonal skills

Customer service

Policy interpretation

Education

Master’s Degree in Behavioral Health

Licensed Behavioral Health Clinician

Tools

Microsoft Office

Outlook

Electronic health record systems

Job description

Cambia Health Solutions, Inc. is seeking a Behavioral Health Utilization Management Clinician to work from home within Oregon, Washington, Idaho or Utah.

You’ll perform prospective, concurrent and retrospective reviews to support medically necessary care while promoting cost-effective outcomes. The role requires a licensed clinician with a master’s in behavioral health and experience in utilization management, using Microsoft Office tools and electronic health records.