Remote Behavioral Health Utilization Clinician

Cambia Health Solutions; Yakima (WA); À distance; USD 48 000 - 79 000; Plein temps

Avantages offerts par ce poste

Medical benefits

401(k) match

Paid time off

Remote work

Résumé du poste

Cambia Health Solutions is seeking a licensed Behavioral Health Clinician to lead utilization management reviews and collaborate with interdisciplinary teams to ensure medically necessary, cost-effective care across multiple states. You will interpret policies, respond to inquiries, and document thoroughly in a remote-friendly environment.

Qualifications include a Master’s in Behavioral Health and 3+ years of UM or behavioral health management experience, with multi-state licensure or

Qualifications

• Master’s degree in Behavioral Health required.
• At least 3 years of utilization management or behavioral health care management experience.
• Must be licensed independently in WA, OR, ID or UT and willing to obtain multi-state licensure.

Responsabilités

• Perform utilization management reviews (prospective, concurrent, retrospective).
• Apply clinical criteria and consult with physician advisors as needed.
• Collaborate with care teams to ensure transitions of care and timely issue resolution.
• Provide prompt, accurate responses to inquiries while delivering strong customer service.
• Identify improvement opportunities and participate in quality initiatives.
• Maintain thorough documentation and protect patient confidentiality.

Connaissances

Behavioral health proficiency

Advanced utilization management

Interpersonal communication

Policy interpretation

Independent workload management

Formation

Master’s degree in Behavioral Health

Outils

Electronic health records

Microsoft Office

Outlook

Description du poste

Cambia Health Solutions is seeking a licensed Behavioral Health Clinician to lead utilization management reviews and collaborate with interdisciplinary teams to ensure medically necessary, cost-effective care across multiple states. You will interpret policies, respond to inquiries, and document thoroughly in a remote-friendly environment.

Qualifications include a Master’s in Behavioral Health and 3+ years of UM or behavioral health management experience, with multi-state licensure or