Behavioral Health Utilization Management Clinician
New
C
CambiaBehavioral health
Work from home within Oregon, Washington, Idaho or UtahFull-TimeMiddle
SalaryOregon, Washington, Utah, and Idaho: The expected hiring range is $36.80 – $49.80 an hour, the full salary range is $34.20 – $55.70 an hour and the bonus target is 8%.
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Job Details
- Experience
- 3 years of utilization management or behavioral health care management experience; 3 years direct Behavioral Health clinical experience as an independently licensed Master's level Behavioral Health Clinician
- Required Skills
- Microsoft Office
Requirements
- Master’s degree in a behavioral health discipline, or an equivalent combination of education and experience.
- At least 3 years of utilization management or behavioral health care management experience.
- At least 3 years of direct behavioral health clinical experience as an independently licensed master’s-level behavioral health clinician.
- Current, unrestricted clinical license in the state of residence.
- Licensed in Washington, Oregon, Idaho, or Utah and willing to be licensed in multiple states.
- Experience in advanced behavioral healthcare settings, including inpatient hospitals, residential facilities, and partial hospital programs.
- Proficiency with Microsoft Office, Outlook, internet search, and general computer skills.
- Familiarity with electronic healthcare documentation systems.
- Ability to interpret and communicate complex policies and procedures.
- Strong organizational, time-management, and critical-thinking skills, with ability to manage workload independently.
Responsibilities
- Conduct prospective, concurrent, and retrospective utilization management reviews.
- Apply clinical expertise and evidence-based criteria to assess medical necessity and policy standards.
- Consult physician advisors as necessary to support accurate determinations.
- Collaborate with interdisciplinary teams, case management, and other departments to facilitate transitions of care and resolve issues.
- Respond promptly and accurately to internal and external inquiries.
- Identify opportunities for improvement and participate in quality improvement initiatives.
- Maintain consistent documentation and prioritize assignments to meet performance standards.
- Protect confidential information and communicate professionally with members, providers, and regulatory organizations.
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