LICSW, LMHC, LMFT, or Psychiatric RN (RN/LPN) - REMOTE

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