Utilization Management Clinician, Behavioral Health – Autism Care Team

Job not on LinkedIn

🔥 16 hours ago

⛷️ Utah – Remote

⛷️ Utah – Remote

💵 $54.1k - $116.8k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

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CVS Health Careers

WebsiteLinkedInAll Job Openings

10,000+ employees

🏥 Healthcare

🛒 Retail

📦 Logistics

Healthcare • Retail • Logistics

CVS Health Careers is the recruitment and employer branding arm of CVS Health, showcasing job opportunities across the company's broad operations—pharmacy retail stores, pharmacy services, health care clinics, distribution warehouses, corporate functions and transportation. The careers site emphasizes purpose-driven work focused on improving access, affordability and quality of health care, and highlights a large workforce (300,000+ employees), inclusive culture, benefits, and hiring resources for applicants.

📋 Description

• Assess appropriateness of treatment plans for ABA services using evidence-based standards and practice guidelines • Coordinate, monitor, and evaluate options to facilitate appropriate healthcare services and benefits for members • Provide triage and crisis support • Gather clinical information and apply clinical criteria, policies, procedures, and judgment to render coverage determinations • Provide providers with determinations and recommendations across the continuum of care and facilitate effective discharge planning • Coordinate with providers and other parties to facilitate optimal care and treatment • Identify members at risk for poor outcomes and facilitate referrals to other products, services, and programs • Conduct member outreach to provide resources and education, answer questions, and offer referrals • Identify opportunities to promote quality and effective healthcare services and benefit utilization • Consult with internal and external constituents regarding utilization and benefit management

🎯 Requirements

• Valid unrestricted independent professional behavioral health clinical license required in the state of residence; acceptable licenses include LPC, LMFT, LCSW, LCPC, LMHC, LCMHC, LICSW, LISW, LBS, LBA, or Clinical Psychologist • 3 years of direct clinical practice experience post master’s degree, such as in a hospital, ambulatory care, or outpatient clinic/facility • 2 years of crisis intervention experience • 3 years of experience working with clients with an autism diagnosis • Residential broadband service with internet speeds of at least 25 Mbps/3 Mbps • Master's degree in Behavioral/Mental Health or Human Service/Health Services • Preferred: previous managed care experience

🏖️ Benefits

• Medical coverage • Dental coverage • Vision coverage • Paid time off • Retirement savings options • Wellness programs • Other resources supporting physical, emotional, and financial well-being • Some candidates may be eligible for partial reimbursement of residential broadband service • CVS Health bonus, commission or short-term incentive program in addition to base pay

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