Healthcare Consultant III - Utilization Management Clinical Consultant – Behavioral Health

Duration: 6 Months contracts

Position Summary

The Utilization Management Clinical Consultant (UMCC) applies clinical expertise and evidence-based criteria to review behavioral health services for adult and child/adolescent members. This role evaluates medical necessity, supports appropriate utilization of benefits, and collaborates with providers to ensure quality, cost-effective care across the continuum of services.

• Key Responsibilities Review clinical documentation to determine medical necessity and appropriateness of behavioral health services
• Apply clinical guidelines and tools such as InterQual, MCG, ASAM, or LOCUS
• Conduct initial, concurrent, and discharge reviews
• Coordinate with healthcare providers regarding authorizations and care planning
• Identify members who may benefit from care management or community resources
• Support continuity of care and safe discharge planning
• Provide urgent or emergent triage support when required
• Ensure accurate documentation and compliance with policies and regulatory standards
• Participate in quality improvement and utilization initiatives

• Required Qualifications Active Arizona license:
• LCSW (Licensed Clinical Social Worker)
• LPC (Licensed Professional Counselor)
• LMFT (Licensed Marriage and Family Therapist)
• OR
• RN with active compact license and behavioral health focus
• Master’s degree required for behavioral health clinicians
• Associate’s degree required for RN applicants
• Experience in behavioral health utilization management or clinical review
• Strong knowledge of medical necessity criteria (InterQual, MCG, ASAM, LOCUS preferred)
• Excellent communication and documentation skills
• Ability to work independently in a remote environment

About US Tech Solutions:

US Tech Solutions is a global staff augmentation firm providing a wide range of talent on-demand and total workforce solutions. To know more about US Tech Solutions, please visit www.ustechsolutions.com .

US Tech Solutions is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, colour, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.

Recruiter Details:

Name: Santwana

Email: santwana.shahi@ustechsolutionsinc.com

Internal Id: 26-03560