Case Manager - RN, LCSW, LPCC, LMFT

Behavioral Health Utilization Management Reviewer (LCSW, LPCC, LMFT, or RN)

$43.66–$56.76 per hour | On-site | Monday–Friday, 8:00 a.m.–5:00 p.m. | Temporary assignment up to 6 months

Put your clinical judgment and utilization review experience to work helping health plan members access appropriate behavioral health services. As part of the Behavioral Health Integration team, you’ll review inpatient and outpatient requests, work directly with providers to gather clinical information, and coordinate cases that need Medical Director review.

What you’ll do

• Review inpatient and outpatient authorization requests for medical necessity using established clinical criteria.
• Gather relevant clinical information, prepare cases for Medical Director review, and communicate decisions to providers and members as appropriate.
• Document reviews, authorization updates, and follow-up in the utilization management system.
• Support care coordination when members transition between care settings.
• Review ICD-10, CPT, and HCPCS codes for accuracy and coverage. Escalate potential overutilization or underutilization to the Medical Director.

What you’ll need

• Current, unrestricted California license as an LCSW, LPCC, LMFT, or RN.
• Prior experience as a utilization management reviewer.
• Related education and three years of clinical experience. An equivalent combination of education and experience may be considered.
• Strong clinical judgment, clear communication, and the ability to manage multiple reviews in a fast-paced environment.

Preferred experience

• Managed care or health plan experience.
• Behavioral health clinical experience.
• Familiarity with behavioral health review criteria used by nonprofit commercial health plans.

This is a fully on-site assignment with standard weekday hours. Flexibility for occasional evening or weekend events may be needed.

360X Staffing is a national staffing and workforce management company headquartered in Phoenix, Arizona, that specializes in providing vetted skilled tradespeople, craftsmen, and professionals for commercial, industrial, and infrastructure projects.