Remote Behavioral Health Utilization Reviewer

COMAGINE HEALTH; Salem (OR); Remote; USD 80,000 - 100,000; Full time

Benefits offered by this job

Medical, dental and vision insurance

Annual workspace stipend

Paid time off

Job summary

COMAGINE HEALTH is seeking a remote utilization review clinician based in Oregon to evaluate medical necessity for behavioral health services. The role involves reviewing clinical documentation, performing initial and continued stay assessments, and coordinating care across in-home and community settings.

You will travel within the Eugene area as needed. Requires active Oregon licensure (LCSW/LPC/LCPC) and 3 years of direct patient care experience, with strong documentation and MS Office skills.

Qualifications

• Active, unrestricted clinical licensure as required (e.g., LCSW, LPC, LCPC) in Oregon.
• Minimum 3 years of direct patient care clinical experience.
• Residence in Oregon and ability to travel.
• Valid driver license and proof of auto insurance.

Responsibilities

• Review clinical documentation to determine medical necessity and service appropriateness.
• Perform initial and ongoing reviews using evidence-based criteria.
• Document utilization review determinations accurately in designated systems.
• Provide SME guidance to stakeholders and support quality activities.
• Refer cases to other clinicians when necessary and coordinate care.

Skills

Clinical licensure

Oregon resident

Travel ability

MS Office

Database software

Tools

MS Office

Database software

Job description

COMAGINE HEALTH is seeking a remote utilization review clinician based in Oregon to evaluate medical necessity for behavioral health services. The role involves reviewing clinical documentation, performing initial and continued stay assessments, and coordinating care across in-home and community settings.

You will travel within the Eugene area as needed. Requires active Oregon licensure (LCSW/LPC/LCPC) and 3 years of direct patient care experience, with strong documentation and MS Office skills.