Clinician, CCR
$73,000–$83,000 year
Remote · United States
Job Summary
Clinician, CCR delivers behavioral health utilization management by conducting clinical reviews, coordinating care, and partnering with providers and internal teams to ensure medically appropriate treatment, effective discharge planning, and positive member outcomes. Responsibilities include conducting clinical reviews across all levels of behavioral health care and applying medical necessity criteria; utilizing clinical judgment and evidence-based practices; coordinating care with members, families, providers, and internal teams; supporting discharge planning and continuity of care; maintaining accurate clinical documentation and adhering to regulatory standards; contributing to quality outcomes by managing caseloads and participating in clinical rounds within established guidelines.
Required Qualifications
- Current, unrestricted license issued by a state or territory of the United States to practice independently as a clinical social worker, marriage and family therapist, professional counselor, clinical psychologist, or registered nurse, and/or other states as required by law, regulation, or contract
- Minimum of two years of direct clinical care experience with patients in facility-based and/or outpatient psychiatric or chemical dependency treatment
- Excellent verbal and written communication and interpersonal skills; strong computer/keyboarding skills including documentation while taking information over the phone
- Ability to comprehend medical policy and criteria to clearly articulate health information
- Ability to pass background check including criminal etc. as listed
- Living our values and teamwork in a remote, home-based setting
- Ability to work independently to meet caseload requirements and in a collaborative team environment
- Comfort with remote work setup (high-speed internet required)
- Ability to maintain accurate clinical documentation in accordance with health plan requirements and regulatory standards
- Proficiency with clinical rounds and discharge planning processes
- Understanding of regulatory standards and utilization management processes
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