Clinician, Clinical Operations - SUD

Lucet•,

7d•$70,000 - $75,000•Remote

About The Position

The Substance Use Disorder (SUD) Clinical Ops Clinician provides integrated care management and utilization management services for members with substance use disorders across the continuum of care. The role conducts clinical assessments, develops individualized care plans, promotes member engagement and recovery, reviews and processes authorization requests, evaluates medical necessity, supports discharge planning, and coordinates referrals to appropriate levels of care and community resources. The clinician collaborates with members, providers, health plans, and community resources to address barriers to treatment and support recovery through education, advocacy, and coordinated interventions. The position also requires accurate clinical documentation, effective use of care management systems, regulatory compliance, participation in quality improvement initiatives, and ongoing professional development. The work is performed from home in a fixed, designated workspace, using company-provided equipment. A quiet workspace and hardwired high-speed internet connection meeting the stated minimum specifications are required. The role involves frequent computer and phone use and extended periods of sitting and typing.

Requirements

Current, active, unrestricted U.S. state or territory license permitting independent practice and assessments, such as Clinical Social Worker, Marriage and Family Therapist, Professional Counselor, Clinical Psychologist, or Registered Nurse, in the state where the business operation is located and/or other states as required by law, regulation, or contract.
At least 2 years of direct clinical care experience in substance use disorder treatment, care management, utilization management, or a related setting.
Demonstrated knowledge of substance use disorders, co-occurring mental health conditions, SUD treatment modalities, and recovery principles.
Knowledge of ASAM Criteria and its application to substance use disorder level-of-care determinations.
Excellent verbal and written communication and interpersonal skills.
Strong computer and keyboarding skills, including Microsoft Office Suite, and the ability to document while taking information over the phone.
Ability to comprehend medical policy and criteria and clearly articulate health information.
Ability to pass the specified background checks and 10-panel drug screen upon hire and throughout employment.
Ability to meet case load requirements and team objectives while working independently.
High-speed internet service installed before starting, with minimum download speed of 20 Mbps, upload speed of 5 Mbps, and maximum latency of 100 milliseconds.
Ability to work from a fixed, designated home workspace with a quiet environment, hardwired internet, and company-issued equipment.

Nice To Haves

Demonstrated interest in professional development through specialization, certification, and/or an advanced degree.

Responsibilities

Conduct comprehensive clinical assessments, utilization reviews, care planning, and care coordination to support appropriate levels of care, recovery-focused treatment, and positive member outcomes.
Review and process authorization requests and evaluate medical necessity.
Facilitate discharge planning and coordinate referrals to appropriate levels of care and community resources.
Partner with members, providers, health plans, and community resources to promote treatment engagement, address barriers to care, and support recovery through education, advocacy, and coordinated interventions.
Maintain accurate clinical documentation, use care management systems effectively, and ensure regulatory compliance.
Participate in quality improvement initiatives and continue developing clinical and industry expertise.

Benefits

Annual compensation of $70,000–$75,000, plus an annual performance-based discretionary incentive.
Medical, dental, and vision coverage.
401(k) with employer match.
Company-paid life and disability insurance.
Paid parental leave and wellbeing incentives.
Paid time off, including volunteer time.
Flexible spending accounts for healthcare and dependent care.
Professional development opportunities and tuition reimbursement.
Remote work flexibility, depending on the role.
Opportunities for personal and professional growth.