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MedNational Staffing
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45.99
HOUR
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Care Review Clinician II
Posted: 05/10/2025
2025-05-10
2025-06-12
Industry: Healthcare
Job Number: 45886430
Pay Rate: $45.99 / hour
Job Description
Job Title: Utilization Management Clinician – Behavioral Health (Remote, WA Licensed)
Pay Rate: $45.99/hour
Contract Type: 6-Month Contract to Hire
Schedule: Full-time, 9:00 AM – 5:00 PM PST (Monday–Friday or Tuesday–Saturday)
Location: Fully Remote (Must be licensed in Washington; must reside in one of the following states: AZ, FL, GA, ID, IA, KY, MI, NE, NM, NY [outside greater-NYC], OH, TX, UT, WA [outside greater-Seattle], or WI)
Position Summary:We are seeking a Behavioral Health Utilization Management Clinician to join our client's team on a full-time, remote basis. This position supports critical Utilization Review functions, ensuring that members receive the right care at the right time in the most appropriate setting. Candidates must have prior experience in Utilization Management and a behavioral health background, with active licensure in the state of Washington.
Key Responsibilities:
Pay Rate: $45.99/hour
Contract Type: 6-Month Contract to Hire
Schedule: Full-time, 9:00 AM – 5:00 PM PST (Monday–Friday or Tuesday–Saturday)
Location: Fully Remote (Must be licensed in Washington; must reside in one of the following states: AZ, FL, GA, ID, IA, KY, MI, NE, NM, NY [outside greater-NYC], OH, TX, UT, WA [outside greater-Seattle], or WI)
Position Summary:We are seeking a Behavioral Health Utilization Management Clinician to join our client's team on a full-time, remote basis. This position supports critical Utilization Review functions, ensuring that members receive the right care at the right time in the most appropriate setting. Candidates must have prior experience in Utilization Management and a behavioral health background, with active licensure in the state of Washington.
Key Responsibilities:
- Conduct utilization reviews for behavioral health services and various levels of care
- Perform prior authorizations and concurrent reviews in accordance with policy and regulatory guidelines
- Collaborate with internal teams including Behavioral Health and Long-Term Care departments
- Consult with medical directors as needed for case evaluation
- Identify appropriate benefits, eligibility, and expected length of stay
- Maintain productivity, quality measures, and documentation accuracy
- Support new staff onboarding and interdepartmental communication
- Ensure compliance with HIPAA, NCQA, and regulatory standards
- Active licensure in the state of Washington as one of the following:
- Licensed Independent Clinical Social Worker (LICSW)
- Licensed Professional Clinical Counselor (LPCC)
- Licensed Mental Health Counselor (LMHC)
- Registered Nurse (RN) with behavioral health background
- Minimum 2–4 years of clinical experience, including inpatient behavioral health, UM, or case management
- Solid knowledge of InterQual or other clinical guidelines
- Strong communication, problem-solving, and organizational skills
- Technologically proficient in Microsoft Office; ability to multitask between systems
- 100% remote work flexibility
- Mission-driven healthcare environment
- Potential for permanent placement after contract period
- Opportunity to support vulnerable populations in receiving timely and appropriate care
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