JOB DESCRIPTION

_This position primarily follows standard working hours of 8:00 AM to 5:00 PM._ **_However, occasional holiday coverage is required, typically limited to approximately 2–4 hours as needed._** _There are no regular weekend or non-standard shift requirements beyond this limited holiday coverage._

_Candidates must hold a valid Washington State license as either a Behavioral Health Clinician or a Registered Nurse (RN) specializing in psychiatric care. Ensuring appropriate licensure at the state level is a mandatory qualification for this role._

Job Summary

Provides support for member clinical service review processes specific to behavioral health. Responsible for verifying that services are medically necessary and align with established clinical guidelines, insurance policies, and regulations, and ensuring members reach desired outcomes through integrated delivery of care across the continuum. Contributes to overarching strategy to pr...