Remote Behavioral Health Utilization Clinician - Impactful Role

Cambia Health Solutions; Utah; Remoto; USD 66.000 - 107.000; Tempo pieno

Vantaggi offerti da questo lavoro

Remote work option

401(k) match

Paid time off

Holidays

Descrizione del lavoro

Cambia Health Solutions is seeking a licensed Behavioral Health Clinician to manage utilization reviews across states, ensuring medical necessity and policy compliance. Remote work is available with state licensure requirements to maintain.

The role emphasizes collaboration with physicians, case management, and quality improvement. The position requires a Master’s in Behavioral Health and at least three years of utilization management or behavioral health care management experience, with

Competenze

• Master’s degree in Behavioral Health required.
• Minimum 3 years of utilization management or behavioral health care management experience.
• Licensed in WA, OR, ID or UT or eligible for multi-state licensure.

Mansioni

• Perform comprehensive utilization management reviews (prospective, concurrent, retrospective).
• Apply clinical criteria to determine medical necessity and policy adherence.
• Collaborate with interdisciplinary teams to ensure safe transitions of care.
• Respond to internal and external inquiries with clear, accurate information.
• Identify opportunities for process and quality improvement in care delivery.
• Maintain meticulous documentation and protect patient confidentiality.

Conoscenze

Utilization management

Behavioral health care management

Clinical license

Interdisciplinary collaboration

Microsoft Office

EHR systems

Communication skills

Time management

Formazione

Master’s Degree in Behavioral Health

Strumenti

Microsoft Office

Outlook

Electronic health records (EHR) systems

Descrizione del lavoro

Cambia Health Solutions is seeking a licensed Behavioral Health Clinician to manage utilization reviews across states, ensuring medical necessity and policy compliance. Remote work is available with state licensure requirements to maintain.

The role emphasizes collaboration with physicians, case management, and quality improvement. The position requires a Master’s in Behavioral Health and at least three years of utilization management or behavioral health care management experience, with