Behavioral Health Utilization Management Clinician
Remote | Louisiana Preferred | Sunday - Thursday Schedule
Are you a licensed Behavioral Health professional or Psychiatric RN looking to make a meaningful impact on members' mental health outcomes? Join our Utilization Management team and play a critical role in ensuring members receive appropriate, evidence-based behavioral health services while supporting quality care and effective treatment planning.
What You'll Do
- Review behavioral health services and treatment plans to determine medical necessity and appropriateness of care
- Apply evidence-based guidelines and clinical best practices across multiple levels of care
- Coordinate and communicate utilization management decisions with providers and care teams
- Provide triage support and crisis intervention as needed
- Facilitate effective discharge planning and transitions of care
- Identify members at risk for poor outcomes and coordinate referrals to additional programs and services
- Promote quality, cost-effective healthcare utilization and positive member outcomes
- Collaborate with internal and external stakeholders to support comprehensive care management
WHAT YOU BRING – REQUIRED
- Active, unrestricted independent Behavioral Health license in Louisiana (LCSW, LCPC, LMFT, LPCC, LPAT, LPC) or
- Active, unrestricted Compact RN license with psychiatric specialty experience
- 3+ years of behavioral health clinical practice experience, such as:
- Psychiatric hospital
- Residential treatment
- Behavioral health treatment settings
- 1+ year of Electronic Medical Record (EMR) documentation experience
- Ability to work Sunday - Thursday, 8:00 AM – 5:00 PM Central Standard Time (CST), with flexibility for occasional weekends and holidays
Preferred Qualifications
- Louisiana residency strongly preferred
- Managed Care, Utilization Review, or Utilization Management experience
- Behavioral health inpatient experience
- Licensed Addiction Counselor (LAC) certification
- Strong multitasking, prioritization, and organizational skills
- Proficiency navigating multiple systems and applications in a fast-paced environment
Education
- Master's degree required for independently licensed Behavioral Health clinicians
- Registered Nurse with psychiatric specialty experience and unrestricted nursing license also considered (Bachelor's Degree in Nursing)
Anticipated Weekly Hours
40
Time Type
Full time
Pay Range
The typical pay range for this role is
$26.01 - $56.14