Behavioral Health Utilization Management Clinician - Remote

Overview

A nationally recognized healthcare organization is seeking a Behavioral Health Utilization Management Clinician to join its high-performing team. This is a 100% remote opportunity supporting members in Washington State. You’ll be a key member of the Utilization Management team, ensuring appropriate, cost-effective, and quality care for behavioral health services through clinical review, coordination, and prior authorizations.

In Short

• Conduct utilization reviews for inpatient and behavioral health levels of care
• Process concurrent and prior authorizations in compliance with organizational policies
• Review member eligibility and benefits to determine appropriate level of care
• Collaborate across internal departments to ensure coordinated care
• Monitor productivity and quality benchmarks while maintaining accurate documentation in EMR systems
• Communicate with providers and internal teams professionally and efficiently
• Participate in staff meetings, training, performance improvement efforts, and audits
• Refer complex cases to medical directors as appropriate

Requirements

• Active, unrestricted clinical license in Washington State: LICSW, LMHC, LMFT, or Psychiatric RN (RN/LPN)
• 2–4+ 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
• Excellent written, verbal, and time management skills
• Proficiency with Microsoft Office and EMR systems
• Reliable high-speed internet and access to a home office setup including monitor and docking station

Benefits

• Competitive hourly pay
• Full medical benefits offered
• Work-from-home flexibility
• Supportive leadership and onboarding