Utilization Management Clinician – Tuesday, Saturday

PacificSource Health Plans

Utilization Management Clinician responsible for assessing healthcare benefits and collaborating with medical professionals at PacificSource. Ensures quality and cost-effective outcomes for member populations through effective healthcare service utilization.

Posted 7/21/2026full-timeMontana • 🇺🇸 United StatesMid-LevelSenior💰 $70,950 - $106,424 per yearWebsite

Core Competencies

Role fit

Core Competencies

Use this summary to align your resume positioning with the role.

Demonstrates expertise in nursing and behavioral health, with a focus on utilization management and case management strategies to ensure quality care and cost-effective outcomes. Holds relevant certifications and licenses to support comprehensive member assessments and care facilitation.

Highest-signal resume keywords

Registered Nurse (RN) LicenseCase Manager CertificationUtilization Management (UM)Behavioral Health ExperienceMedical Processes Knowledge

ATS Keywords

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Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard Skills

Nursing ExperienceBehavioral Health ExperienceUtilization ManagementConcurrent ReviewCase Management Plans

Soft Skills

CollaborationCommunicationAssessment Skills

Certifications & Qualifications

Registered Nurse (RN)LPCLMFTLCSWPMHNP

Industry Keywords

Health Plan BenefitsMember CareCost-Effective OutcomesMedical ProfessionalsNon-Medical Professionals

About the role

Key responsibilities & impact

Collaborate closely with physicians, nurses, social workers, and a wide range of medical and non-medical professionals
Assess the member’s specific health plan benefits
Provide utilization management (UM) services promoting quality, cost-effective outcomes
Facilitate outstanding member care using fiscally responsible strategies
Perform concurrent review of members admitted to inpatient facilities

Requirements

What you’ll need

Minimum of three (3) years of nursing or behavioral health experience
Active, unrestricted Registered Nurse (RN) license, LPC, LMFT, LCSW, or PMHNP credential required
Case Manager Certification as accredited by CCMC preferred
Thorough knowledge of medical and behavioral health processes, diagnoses, care modalities
Understanding of appropriate case management plans

Benefits

Comp & perks

Flexible telecommute policy
medical, vision, and dental insurance
incentive program
paid time off and holidays
401(k) plan
volunteer opportunities
tuition reimbursement and training
life insurance
options such as a flexible spending account