Remote Behavioral Health Utilization Consultant (AZ Licensed)

VIVA USA Inc; Arizona; Remote; USD 90,000 - 125,000; Full time

Job summary

VIVA USA Inc. is hiring a Utilization Management Clinical Consultant (UMCC) for a remote role that requires an active Arizona BH license.

The UMCC applies clinical expertise to assess medical necessity and quality of behavioral health services for adults and children/adolescents, collaborating with providers and internal teams to authorize care across the continuum. The position emphasizes review, coordination, and timely decision-making, with a focus on cost-effective, high-quality care.

Qualifications

• Master’s degree in Behavioral Health required for clinicians.
• Associate’s degree required for RN applicants.
• Working knowledge of behavioral health terminology and utilization management principles.

Responsibilities

• Review clinical information and apply medical necessity criteria to render coverage determinations and discharge planning.
• Analyze medical records to ensure alignment with evidence-based standards and quality benchmarks.
• Coordinate with providers, teams, and stakeholders to facilitate timely, appropriate care and authorization decisions.
• Conduct concurrent reviews to monitor ongoing treatment and continuity of care.
• Identify members who may benefit from care management programs and referrals.
• Provide urgent clinical interventions as needed, including triage and crisis support.
• Educate providers on utilization management processes and guidelines under supervision.
• Develop initiatives to enhance quality and benefit utilization.
• Prepare clinical reports to track utilization outcomes.

Skills

Behavioral Health UM

Clinical Documentation

Critical Thinking

Communication

Digital Literacy

Cultural Competence

Education

Master’s in Behavioral Health

Associate’s in Nursing (RN)

Job description

VIVA USA Inc. is hiring a Utilization Management Clinical Consultant (UMCC) for a remote role that requires an active Arizona BH license.

The UMCC applies clinical expertise to assess medical necessity and quality of behavioral health services for adults and children/adolescents, collaborating with providers and internal teams to authorize care across the continuum. The position emphasizes review, coordination, and timely decision-making, with a focus on cost-effective, high-quality care.