Utilizes clinical skills to coordinate, document, and communicate all aspects of the utilization/benefit management program
Applies critical thinking and knowledge in clinically appropriate treatment
Consults and lends expertise to other internal and external constituents
Gathers clinical information and applies the appropriate medical necessity criteria/guideline
Evaluates and facilitates appropriate healthcare services/benefits for members
Coordinates and communicates with providers and other parties for optimal care
Identifies members who may benefit from care management programs and facilitates referral
Identifies opportunities to promote quality effectiveness of healthcare services

Active and good standing Arizona clinical and/or counseling license, specifically RN, LPC, LAC, LMFT, LMAFT, LMSW, or LCSW
Ability to work Monday-Friday from 8am-5pm (Arizona Time)
Ability to travel up to 10% of the time within the United States
Previous experience working within the mental health system (preferred)
Ability to collaborate with various internal departments (preferred)
Strong communication skills (preferred)
Strong organizational and time management skills (preferred)

Utilization Management Clinical Consultant

Key skills