UM Clinician — Quality Care & Resource Navigation

PacificSource; Boise (ID); On-site; USD 71,000 - 106,000; Full time

Job summary

PacificSource is hiring an Utilization Management Clinician to work Tuesday through Saturday in Boise, ID. This full-time role collaborates with physicians, nurses, social workers, and other professionals to coordinate care and promote cost-effective outcomes.

Minimum 3 years nursing or behavioral health experience is required along with an active RN, LPC, LMFT, LCSW, or PMHNP license. Travel about 5% is expected. The role emphasizes HIPAA-compliant documentation and teamwork.

Qualifications

• Active, unrestricted RN, LPC, LMFT, LCSW, or PMHNP credential required.
• Minimum of three (3) years of nursing or behavioral health experience.
• CCMC Case Manager Certification preferred.

Responsibilities

• Collect and assess member information to promote wellness and cost-effective care.
• Coordinate resources to achieve member outcome goals.
• Document case notes and explanations for legal records.
• Perform concurrent review of inpatients, residential treatments, and partial hospitalization.
• Review referrals for appropriateness of care per evidence-based criteria.
• Collaborate with physicians and other professionals for member care.
• Identify high-cost utilization and refer to Care Management teams.
• Maintain HIPAA privacy and confidentiality.

Skills

Accountability

Collaboration

Communication

Flexibility

Listening

Organizational skills

Problem Solving

Teamwork

Education

RN license

LPC

LMFT

LCSW

PMHNP

CCMC Case Manager Certification

Tools

EHR systems

Job description

PacificSource is hiring an Utilization Management Clinician to work Tuesday through Saturday in Boise, ID. This full-time role collaborates with physicians, nurses, social workers, and other professionals to coordinate care and promote cost-effective outcomes.

Minimum 3 years nursing or behavioral health experience is required along with an active RN, LPC, LMFT, LCSW, or PMHNP license. Travel about 5% is expected. The role emphasizes HIPAA-compliant documentation and teamwork.