Remote Clinical Utilization & Behavioral Health Specialist

Community Health Options; Maine; Remote; USD 60,000 - 80,000; Full time

Benefits offered by this job

Flexible schedules

Professional development opportunities

Commitment to diversity and inclusion

Job summary

A healthcare organization in Maine is seeking a Clinical Specialist to provide clinical decision-making support and coordinate community resources. The ideal candidate will have at least two years of behavioral health experience and must possess a valid nursing license in Maine. This role is remote and requires strong communication and customer service skills. Responsibilities include conducting medical necessity reviews and ensuring effective program coordination for health services. Join a team committed to diversity, equity, and inclusion in a supportive environment.

Qualifications

• Completion of an accredited registered nursing (RN) or licensed practical nursing (LPN) degree program.
• Minimum of one year of experience in Utilization Management/Utilization Review.
• Minimum of two years of behavioral health clinical experience required.
• Current, unrestricted Maine Registered Nurse license (RN) or compact state RN license or Maine Licensed Practical Nurse (LPN) license or compact state LPN license required.

Responsibilities

• Provides clinical decision-making support and community resource coordination.
• Performs medical necessity reviews for behavioral health care services.
• Efficiently coordinates medical services to facilitate members receiving care.

Skills

Proficient in English

Clinical documentation

Interpersonal communication

Customer service

Education

Accredited registered nursing (RN) or licensed practical nursing (LPN) degree

Tools

Microsoft Office

Job description

A healthcare organization in Maine is seeking a Clinical Specialist to provide clinical decision-making support and coordinate community resources. The ideal candidate will have at least two years of behavioral health experience and must possess a valid nursing license in Maine. This role is remote and requires strong communication and customer service skills. Responsibilities include conducting medical necessity reviews and ensuring effective program coordination for health services. Join a team committed to diversity, equity, and inclusion in a supportive environment.