Cambia Health Solutions
Behavioral Health Utilization Management Clinician
Cambia Health Solutions, Olympia, Washington, United States
Work from Home : Eligible to work remotely from Oregon, Washington, Idaho, or Utah.
Weekend Coverage : Participates in a weekend rotation (approximately 6 days per year).
Standard Hours : Aligns with Pacific Standard Time business hours (8:00 am–5:00 pm PST) regardless of geographic location.
About Cambia Build a career with purpose. Join our Cause to create a person‑focused and economically sustainable health care system. Cambia’s dedicated team of Clinicians lives our mission daily to make health care easier and lives better.
Qualifications
Master’s Degree in a Behavioral Health Discipline
3 years of utilization management or behavioral health care management experience, or an equivalent combination of education and experience
3 years of direct Behavioral Health clinical experience as an independently licensed Master's level Behavioral Health Clinician (Psychology, Counseling, Social Work, Marriage or Family Therapy)
Unrestricted and current clinical license in the state of residence; licensed in WA, OR, ID or UT and willing to obtain licenses in additional states
Skills and Attributes
Proficiency in advanced behavioral‑healthcare settings including inpatient hospitals, residential facilities, and partial hospital programs
Staying abreast of developments in the health‑insurance industry, including trends, technological advancements, and contractual agreements
General computer skills (Microsoft Office, Outlook, internet search)
Familiarity with electronic health‑care documentation systems
Exceptional verbal, written, and interpersonal communication skills with a strong focus on customer service
Strong organizational and time‑management skills; ability to prioritize workload independently
Critical‑thinking skills; ability to make informed decisions within scope of role
What You Will Do
Perform comprehensive utilization management reviews (prospective, concurrent, retrospective) to ensure medical necessity and policy adherence
Apply clinical expertise and evidence‑based criteria to make informed determinations, consulting with physician advisors as needed
Collaborate with interdisciplinary teams, case management, and other departments to facilitate seamless transitions of care and resolve issues promptly
Serve as a trusted resource, providing accurate responses to internal and external inquiries with exceptional customer service
Identify improvement opportunities and participate in quality‑improvement initiatives
Maintain meticulous, consistent documentation and prioritize assignments to meet performance standards and corporate objectives
Uphold confidentiality of sensitive information and communicate professionally with members, providers, and regulatory organizations
Compensation The expected hourly range is $42.00–$44.00, depending on skills, experience, education, and training.
Bonus target: 10%. Full salary range: $33.80–$55.00 per hour.
Benefits #J-18808-Ljbffr
Weekend Coverage : Participates in a weekend rotation (approximately 6 days per year).
Standard Hours : Aligns with Pacific Standard Time business hours (8:00 am–5:00 pm PST) regardless of geographic location.
About Cambia Build a career with purpose. Join our Cause to create a person‑focused and economically sustainable health care system. Cambia’s dedicated team of Clinicians lives our mission daily to make health care easier and lives better.
Qualifications
Master’s Degree in a Behavioral Health Discipline
3 years of utilization management or behavioral health care management experience, or an equivalent combination of education and experience
3 years of direct Behavioral Health clinical experience as an independently licensed Master's level Behavioral Health Clinician (Psychology, Counseling, Social Work, Marriage or Family Therapy)
Unrestricted and current clinical license in the state of residence; licensed in WA, OR, ID or UT and willing to obtain licenses in additional states
Skills and Attributes
Proficiency in advanced behavioral‑healthcare settings including inpatient hospitals, residential facilities, and partial hospital programs
Staying abreast of developments in the health‑insurance industry, including trends, technological advancements, and contractual agreements
General computer skills (Microsoft Office, Outlook, internet search)
Familiarity with electronic health‑care documentation systems
Exceptional verbal, written, and interpersonal communication skills with a strong focus on customer service
Strong organizational and time‑management skills; ability to prioritize workload independently
Critical‑thinking skills; ability to make informed decisions within scope of role
What You Will Do
Perform comprehensive utilization management reviews (prospective, concurrent, retrospective) to ensure medical necessity and policy adherence
Apply clinical expertise and evidence‑based criteria to make informed determinations, consulting with physician advisors as needed
Collaborate with interdisciplinary teams, case management, and other departments to facilitate seamless transitions of care and resolve issues promptly
Serve as a trusted resource, providing accurate responses to internal and external inquiries with exceptional customer service
Identify improvement opportunities and participate in quality‑improvement initiatives
Maintain meticulous, consistent documentation and prioritize assignments to meet performance standards and corporate objectives
Uphold confidentiality of sensitive information and communicate professionally with members, providers, and regulatory organizations
Compensation The expected hourly range is $42.00–$44.00, depending on skills, experience, education, and training.
Bonus target: 10%. Full salary range: $33.80–$55.00 per hour.
Benefits #J-18808-Ljbffr