Utilization Management Clinical Consultant

For our client, we are seeking a Utilization Management Clinical Consultant to join the team of a leader in the Healthcare space. This remote role will focus on clinical utilization management for behavioral health members, with an emphasis on evaluating medical necessity, supporting appropriate care decisions, and helping guide effective treatment and discharge planning. The consultant will partner with internal teams, external providers, and other stakeholders to coordinate benefit management activities and support access to the right level of care. Location: Remote - US based candidates only, no visa sponsorship available Compensation: $108,000 – $155,000 annually Responsibilities Coordinate, document, and communicate all aspects of the utilization and benefit management program Apply critical thinking and medical necessity criteria for child and adolescent care Consult with internal and external parties regarding utilization management Gather clinical information to render coverage recommendations and discharge planning Evaluate and facilitate appropriate healthcare services for members, including urgent interventions Communicate with providers to ensure optimal care and treatment Identify and refer members to care management programs Qualifications 2+ years of experience in a clinical behavioral health setting with a focus on utilization management Active Arizona clinical and/or counseling license, such as RN, LPC, LAC, LMFT, LMSW, or LCSW Availability to work Monday-Friday, 8am-5pm, with occasional weekends and holidays Willingness to travel up to 10% within Phoenix, AZ Benefits Comprehensive medical, dental, and vision coverage Paid time off to support work-life balance Retirement savings options for future financial security Access to wellness programs to promote overall well-being Additional resources for employee and family support Our client is an equal opportunity employer. We encourage you to apply even if you don’t meet every qualification—your background could be exactly what this team needs.