Clinician, Clinical Response

The Clinician, Clinical Response provides clinical customer service, utilization management support, and operational guidance to members, families, providers, and internal teams. This role involves conducting clinical telephonic screenings, supporting member crisis calls, facilitating referrals to behavioral health and community resources, and maintaining thorough documentation. The position requires clinical expertise in medical necessity criteria, health plan nuances, and member crisis support within a 24/7/365 call center model.