Behavioral Health Utilization Management Clinician

Overview

Behavioral Health Utilization Management Clinician Our client is seeking a Behavioral Health Utilization Management Clinician to support utilization review activities across a continuum of behavioral health services. This role applies clinical judgment, evidence-based criteria, and regulatory standards to ensure appropriate, high-quality care while collaborating closely with internal teams, providers, and other stakeholders. The position aligns with Pacific Time business hours and includes limited weekend coverage as part of a rotating schedule.

This role is fully remote. Applicants must work PST hours with occasional weekend shifts and be located in Oregon, Washington, Idaho or Utah.

• Conduct prospective, concurrent, and retrospective utilization reviews to assess medical necessity, benefit coverage, and policy compliance.
• Apply clinical expertise and established guidelines to support utilization decisions, consulting with physician advisors when escalation or additional review is required.
• Partner with care management, interdisciplinary teams, and related departments to promote timely care coordination and smooth transitions across levels of care.
• Serve as a knowledgeable point of contact for utilization-related inquiries, delivering responsive, accurate, and service-oriented support.
• Ensure clear, thorough, and timely documentation that meets regulatory requirements, internal standards, and performance expectations.
• Participate in quality improvement efforts by identifying trends, risks, and opportunities to enhance utilization processes and outcomes.
• Maintain strict confidentiality and communicate professionally with members, providers, and regulatory entities in accordance with applicable privacy standards.

• Master’s degree in a behavioral health discipline such as Social Work, Counseling, Psychology, or Marriage and Family Therapy.
• Active, unrestricted independent clinical license in the state of residence, with licensure in WA, OR, , or UT and willingness to obtain additional state licenses as required.
• Minimum of three years of utilization management or behavioral health care management experience, or an equivalent combination of education and experience.
• At least three years of direct clinical experience practicing independently in a behavioral health setting.
• Demonstrated experience across higher-acuity levels of care, including inpatient, residential, and partial hospitalization programs.
• Strong ability to interpret, apply, and clearly communicate complex clinical guidelines, policies, and procedures.
• Excellent written, verbal, and interpersonal communication skills, with a strong emphasis on professionalism and customer service.
• Proficiency with electronic health record systems, clinical documentation platforms, and standard computer applications such as Microsoft Office and Outlook.
• Proven organizational, time management, and critical-thinking skills, with the ability to work independently and manage competing priorities.

Compensation: (DOE)

Vander Houwen Contractors Enjoy Exceptional Benefit Perks!
As an eligible contract employee with Vander Houwen, you’ll have access to a full suite of benefits designed with your well-being in mind. Our comprehensive package includes medical, dental, vision, life insurance, short- and long-term disability, and a matching 401(k) to help secure your future.

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