Utilization Management Clinician

Job Description

Job Description

Job Title: Utilization Management Clinician – Behavioral Health (Remote, WA Licensed)
Pay Rate: $45.99/hour
Contract Type: 6-Month Contract to Hire
Schedule: Full-time, 9:00 AM – 5:00 PM PST (Monday–Friday or Tuesday–Saturday)
Location: Fully Remote (Must be licensed in Washington; must reside in one of the following states: AZ, FL, GA, ID, IA, KY, MI, NE, NM, NY [outside greater-NYC], OH, TX, UT, WA [outside greater-Seattle], or WI)

Position Summary:

We are seeking a Behavioral Health Utilization Management Clinician to join our client's team on a full-time, remote basis. This position supports critical Utilization Review functions, ensuring that members receive the right care at the right time in the most appropriate setting. Candidates must have prior experience in Utilization Management and a behavioral health background, with active licensure in the state of Washington.

Key Responsibilities:

• Conduct utilization reviews for behavioral health services and various levels of care

• Perform prior authorizations and concurrent reviews in accordance with policy and regulatory guidelines

• Collaborate with internal teams including Behavioral Health and Long-Term Care departments

• Consult with medical directors as needed for case evaluation

• Identify appropriate benefits, eligibility, and expected length of stay

• Maintain productivity, quality measures, and documentation accuracy

• Support new staff onboarding and interdepartmental communication

• Ensure compliance with HIPAA, NCQA, and regulatory standards

Required Qualifications:

• Active licensure in the state of Washington as one of the following:

  • Licensed Independent Clinical Social Worker (LICSW)

  • Licensed Professional Clinical Counselor (LPCC)

  • Licensed Mental Health Counselor (LMHC)

  • Registered Nurse (RN) with behavioral health background

• Minimum 2–4 years of clinical experience, including inpatient behavioral health, UM, or case management

• Solid knowledge of InterQual or other clinical guidelines

• Strong communication, problem-solving, and organizational skills

• Technologically proficient in Microsoft Office; ability to multitask between systems

Equipment Requirements:

Candidates must provide their own monitor and docking station; all other equipment (laptop, headset, mouse, keyboard) will be supplied.

Why Apply?

• 100% remote work flexibility

• Mission-driven healthcare environment

• Potential for permanent placement after contract period

• Opportunity to support vulnerable populations in receiving timely and appropriate care

Apply today to make a meaningful impact in behavioral health and utilization management!

Company DescriptionUsing the best business practices obtained from many years of experience in Business, Law, and Recruiting and Staffing, the Founders at CrossFire Group (“CrossFire”) started in downtown Royal Oak, MI more than a decade ago. With backgrounds in Information Technology (IT) and the Legal Industry, CrossFire began placing by IT and Legal Professionals in contract and direct-hire positions throughout the Midwest.

Since our founding, CrossFire has grown into a full-service Human Capital Solutions Organization. We are proud of now providing full services beyond recruiting and staffing. Our portfolio of services includes HR supply chain management, human resources consulting, and many customized Human Resource related services.

Company Description

Using the best business practices obtained from many years of experience in Business, Law, and Recruiting and Staffing, the Founders at CrossFire Group (“CrossFire”) started in downtown Royal Oak, MI more than a decade ago. With backgrounds in Information Technology (IT) and the Legal Industry, CrossFire began placing by IT and Legal Professionals in contract and direct-hire positions throughout the Midwest.\r\n\r\nSince our founding, CrossFire has grown into a full-service Human Capital Solutions Organization. We are proud of now providing full services beyond recruiting and staffing. Our portfolio of services includes HR supply chain management, human resources consulting, and many customized Human Resource related services.