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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