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adecco
Behavioral Health Utilization Management Clinician
Career Insights for Mental / Behavioral Health Social Worker
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What they do
A Mental or Behavioral Health Social Worker assesses and treats individuals with mental, emotional, or substance abuse problems. Activities may include individual and group therapy, crisis intervention, case management, client advocacy, prevention, and education.
$60,789 / year median in the U.S.
+7% projected growth
Job Description
Adecco Healthcare & Life Sciences is currently hiring a Behavioral Health Utilization Management Clinician for a remote telecommute opportunity in Nevada . This is a remote opportunity with a Monday-Friday schedule. Please review the details below and apply with an updated resume for consideration.
Position Details:
Pay:
$39 to $ 41.40/hourContract:
Four to Six-Contract, possibility of extension or becoming permanentLocation:
Remote / TelecommuteSchedule:
Monday-Friday, 8:00 AM-5:00PM PST Primary Responsibilities:
- Review outpatient ABA requests for medical necessity using established clinical criteria, including MCG, InterQual, ASAM, and plan-specific guidelines.
- Evaluate treatment plans, progress reports, assessments, and supporting documentation submitted by providers.
- Collaborate with providers to clarify documentation and ensure the appropriate level of care.
- Make determinations or recommendations for approval, modification, or denial of services.
- Document clinical decisions and rationale accurately in the utilization management system.
- Review clinical information and apply established guidelines to support appropriate behavioral health services.
- Manage multiple cases in a high-volume, deadline-driven environment.
- Collaborate with internal clinical and administrative teams to support quality patient care.
Qualifications:
- BCBA, LBA, RN, Master's degree in Social Work, or related behavioral health field.
- LCSW, LPC, LMFT, or equivalent behavioral health credentials accepted.
- Active, unrestricted behavioral health license in the State of Nevada preferred.
- Minimum of 2 years of behavioral health clinical experience, including ABA experience.
- Familiarity with Medicaid and commercial benefit structures and utilization management protocols.
- Experience reviewing clinical documentation and determining medical necessity.
- Ability to work independently and effectively within a remote team environment.
- Proficiency with clinical systems, Microsoft Office applications, and electronic documentation platforms.
- Strong ability to multitask and meet deadlines in a high-volume environment.
- Experience in behavioral health utilization management or prior authorization. Why Work for Adecco?
- Excellent Weekly Pay
- 401(k) Plan
- Skills Training