LICSW, LMHC, LMFT, or Psychiatric RN (RN/LPN) – REMOTE Position Available In Duval, Florida

Utilization Management Clinician – Behavioral Health (Remote)

Pay:

$42/hour +

Full Medical Benefits Schedule:

Monday-Friday, 9:00am-5:00pm EST (or Tuesday-Saturday)

Employment Type:

Long-Term Contract Location:

Remote – Must be located in EST or CST willing to work EST schedule 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