Behavioral Health Utilization Management Clinician I – RN

Community Health Plan of Washington

Utilization Management Clinician I conducting medical and behavioral health reviews at Community Health Plan of Washington. Collaborating with healthcare team for optimal patient outcomes in a hybrid role.

Posted 7/15/2026full-timeSeattle • Washington • 🇺🇸 United StatesJuniorMid-Level💰 $36 - $56 per hourWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in Utilization Management and clinical decision-making, ensuring timely access to care and effective communication of policies and procedures. Collaborates with healthcare teams to implement cost-effective alternatives and achieve optimal patient outcomes.

Highest-signal resume keywords

Utilization ManagementClinical ExperienceRN LicenseBehavioral HealthManaged Care

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Utilization ReviewClinical AssessmentCare CoordinationPatient AdvocacyDecision Support

Soft Skills

CollaborationCommunicationProblem-SolvingInterpersonal Skills

Certifications & Qualifications

Registered Nurse LicenseLicensed Practical Nurse License

Industry Keywords

Community Health Plan of WashingtonHealthcare TeamPatient OutcomesTransitions of CareCost-Effective Alternatives

About the role

Key responsibilities & impact

The Level I Utilization Management Clinician performs utilization review for medical or behavioral health requests using utilization review criteria, technologies, and tools.
Identifies, coordinates, and implements high quality, cost-effective alternatives when appropriate to the patient’s condition.
Supports physician decision-making, working collaboratively with all members of the health care team, the patient, the patient’s family, co-workers, and internal and external customers to achieve optimal patient outcomes.
Ensures members have timely access to care and supports during transitions between levels of care.
Understands and effectively communicates requirements and follows Community Health Plan of Washington (CHPW) policies and procedures.

Requirements

What you’ll need

Have a bachelor’s degree in a relevant field or an equivalent combination of education and highly relevant experience.
Have a current, unrestricted license as an RN or LPN.
Have at least two years clinical experience in either a physical health or behavioral health setting.
Have previous experience in Utilization Management and Managed Care, preferred.

Benefits

Comp & perks

Medical, Prescription, Dental, and Vision
Telehealth app
Flexible Spending Accounts, Health Savings Accounts
Basic Life AD&D, Short and Long-Term Disability
Voluntary Life, Critical Care, and Long-Term Care Insurance
401(k) Retirement and generous employer match
Employee Assistance Program and Mental Fitness app
Financial Coaching, Identity Theft Protection
Time off including PTO accrual starting at 17 days per year. 40 hours Community Service volunteer time 10 standard holidays, 2 floating holidays
Compassion time off, jury duty