Utilization Management Clinician – Behavioral Health
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
