Job Summary
A company is looking for a Behavioral Health Utilization Management Clinician to join its remote team.
Key Responsibilities
- Conduct utilization reviews for inpatient and behavioral health levels of care
- Process concurrent and prior authorizations in compliance with organizational policies
- Collaborate across internal departments to ensure coordinated care
Required Qualifications
- Active, unrestricted clinical license in Washington State: LICSW, LMHC, LMFT, or Psychiatric RN (RN/LPN)
- 24+ years of clinical experience in behavioral health, utilization management, case management, or hospital settings
- Strong knowledge of medical necessity guidelines, including InterQual
- Familiarity with NCQA and HIPAA compliance
- Reliable high-speed internet and access to a home office setup including monitor and docking station
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