Utilization Management Clinician – Behavioral Health (Remote)
Pay: $45/hour + Full Medical Benefits
Schedule: Monday–Friday, 9:00am–5:00pm PST (or Tuesday–Saturday)
Employment Type: Long-Term Contract
Location: Remote – Must be licensed in Washington State

About the Opportunity
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.

Key Responsibilities

• 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 (Behavioral Health, Long-Term Care, etc.) 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

Required Qualifications

• 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

Preferred Experience

• Behavioral health or psychiatric care background

• Familiarity with UM reviews and prior authorization protocols

• Experience with concurrent review, discharge planning, or crisis intervention

Perks & Benefits

• Competitive hourly pay

• Full medical benefits offered

• Work-from-home flexibility

• Supportive leadership and onboarding

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