Remote Utilization Management Coordinator

Greater-Oregon-Behavioral-Healt; Eugene (OR); Remote; USD 77,000 - 94,000; Full time

Benefits offered by this job

Competitive salary starting at $85,000

Spanish bilingual premium

Medical, dental and vision insurance

22 paid time off days

Flexible schedule

Life, disability insurance

FSA with employer contribution

401k with employer contributions

Mileage reimbursement

Wellness benefits

Cell phone and internet reimbursement

Job summary

Greater Oregon Behavioral Health, Inc. (GOBHI) is seeking a Utilization Management Coordinator for a remote office role located in Oregon.

The role provides clinical expertise in mental health and substance use treatment, focusing on reviews against medical necessity criteria and improving health outcomes. Essential duties include reviewing authorization requests, issuing notices, collaborating with providers and state/county partners, and supporting care coordination staff.

Qualifications

• Master’s degree in behavioral health is required.
• Licensed clinical social worker (LCSW) or licensed professional counselor (LPC) is required.
• Five years’ experience with individuals with severe and persistent mental illness is required.
• Ability to communicate effectively at multiple levels is essential.
• Proficient using MS Office or Google Suites.

Responsibilities

• Review authorization requests to ensure required information is provided and request missing data.
• Review medical, mental health and substance use information and make authorization decisions based on criteria and clinical judgment.
• Issue decision notices based on established unit protocols.
• Collaborate with community providers, state/county case workers, vendors, and wraparound teams.
• Gather and assemble documents for appeals, reconsiderations, and retrospective/review requests.
• Provide direction to non-clinical Care Coordination staff involved with members.
• Offer technical assistance to providers in person and via video.
• Review and stay updated on contract expectations for authorizations.
• Travel to GOBHI locations as needed.

Skills

Communication

Attention to detail

Networking / Resourcefulness

Tech savvy (MS Office / Google Suites)

Driving record & insurance

On-call availability

Education

Master’s degree in behavioral health

Licensed Clinical Social Worker (LCSW) or Licensed Professional Counselor (LPC)

Tools

MS Office / Google Suites

Job description

Greater Oregon Behavioral Health, Inc. (GOBHI) is seeking a Utilization Management Coordinator for a remote office role located in Oregon.

The role provides clinical expertise in mental health and substance use treatment, focusing on reviews against medical necessity criteria and improving health outcomes. Essential duties include reviewing authorization requests, issuing notices, collaborating with providers and state/county partners, and supporting care coordination staff.