Utilization Management Clinician – Behavioral Health

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🔥 3 minutes ago

🌵 Arizona – Remote

🌵 Arizona – Remote

💵 $60.5k - $129.6k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

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CVS Health

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1963

⚕️ Healthcare Insurance

🛒 Retail

🧘 Wellness

Healthcare Insurance • Retail • Wellness

CVS Health is a leading American healthcare company dedicated to improving health access and affordability. The company focuses on a comprehensive approach that includes health services, health insurance, and pharmacy benefits management. Through its subsidiaries, such as Aetna and CVS Caremark, CVS Health offers a range of services that facilitate wellness, condition management, and affordable prescription drug coverage. CVS Health operates neighborhood pharmacies, provides mail-order pharmacy services, and manages specialty medication programs, aiming to make healthcare convenient and accessible for everyone. Driven by a mission to connect people with essential care services, CVS Health is committed to fostering healthier communities and supporting the wellbeing of all individuals.

📋 Description

• Provides high-level scope of role and leadership in the utilization management process for behavioral health services • Conducts comprehensive assessments and evaluations of members' behavioral health needs • Supports the core purpose of the job by collaborating with providers, members, and multidisciplinary teams • Applies in-depth knowledge and clinical skills to coordinate, document, and communicate all aspects of the utilization/benefit management program • Reviews and analyzes clinical documentation, treatment plans, and progress notes • Stays updated on industry guidelines, evidence-based practices, and emerging trends in behavioral health • Collaborates with stakeholders, establishing effective communication channels for care coordination • Provides coaching and guidance to support the professional development of the UM team • Ensures a culture of continuous improvement and best practices

🎯 Requirements

• Active, unrestricted, independent clinical licensure in good standing • 3–5 years of behavioral health clinical experience • Strong clinical assessment, problem-solving, and decision-making skills • Knowledge of medical terminology and utilization management principles • Ability to manage sensitive information with professionalism and discretion • Must be willing to work in MST or PST • Bachelor's or Master's degree in a relevant field, or equivalent professional training and qualifications

🏖️ Benefits

• medical, dental, and vision coverage • paid time off • retirement savings options • wellness programs • other resources, based on eligibility