Utilization Management Clinician – Behavioral Health

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Job Description:

  • Provides high-level scope of role and leadership in the utilization management process for behavioral health services
  • Conducts comprehensive assessments and evaluations of members' behavioral health needs
  • Supports the core purpose of the job by collaborating with providers, members, and multidisciplinary teams
  • Applies in-depth knowledge and clinical skills to coordinate, document, and communicate all aspects of the utilization/benefit management program
  • Reviews and analyzes clinical documentation, treatment plans, and progress notes
  • Stays updated on industry guidelines, evidence-based practices, and emerging trends in behavioral health
  • Collaborates with stakeholders, establishing effective communication channels for care coordination
  • Provides coaching and guidance to support the professional development of the UM team
  • Ensures a culture of continuous improvement and best practices

Requirements:

  • Active, unrestricted, independent clinical licensure in good standing
  • 3–5 years of behavioral health clinical experience
  • Strong clinical assessment, problem-solving, and decision-making skills
  • Knowledge of medical terminology and utilization management principles
  • Ability to manage sensitive information with professionalism and discretion
  • Must be willing to work in MST or PST
  • Bachelor's or Master's degree in a relevant field, or equivalent professional training and qualifications

Benefits:

  • medical, dental, and vision coverage
  • paid time off
  • retirement savings options
  • wellness programs
  • other resources, based on eligibility
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