Behavioral Health Utilization Manager (Temporary)

About the role

Atlantic Group is hiring a Behavioral Health Utilization Manager (Temporary) in Boston, MA for our client, supporting behavioral health utilization management, medical necessity reviews, and clinical care decisions for outpatient mental health and substance use services. This role will evaluate service requests, document clinical determinations, and collaborate with providers and interdisciplinary teams to promote appropriate care.

Responsibilities

• Utilization Review: Review behavioral health service requests and assess medical necessity and appropriate levels of care using established clinical criteria.
• Clinical Assessment: Apply clinical judgment to behavioral health cases and support appropriate care determinations.
• Care Coordination: Identify additional care needs and connect members with appropriate behavioral health and care management resources.
• Clinical Documentation: Maintain accurate and timely documentation of clinical reviews, determinations, and related case activity.
• Provider Collaboration: Communicate with healthcare providers and clinical teams to address utilization questions and support coordinated care.
• Quality & Compliance: Support quality improvement initiatives and ensure utilization review activities align with applicable clinical and regulatory standards.

Qualifications

• Education: Master's degree in Social Work, Psychology, Counseling, or a related behavioral health field is required.
• Licensure: Active independent clinical licensure in a behavioral health discipline is required.
• Experience: Minimum of 5 years of behavioral health experience, including utilization management, utilization review, or managed care experience, is required.
• Industry Knowledge: Strong knowledge of behavioral health, medical necessity review, utilization management, and managed care is required.
• Technical Skills: Proficiency with Microsoft Office and healthcare case management or clinical systems is required.
• Skills & Attributes: Strong clinical judgment, analytical, communication, and organizational skills with the ability to independently manage complex cases and multiple priorities.

Location: Boston, MA
Schedule: Monday to Friday (Remote)
Compensation: $44/hour
Type: Temporary