Behavioral Health Utilization Clinician

4004 Aetna Medicaid Administrators; Arizona; Hybrid; USD 36,000 - 103,000; Full time

Benefits offered by this job

Medical, dental, and vision coverage

Paid time off

Retirement savings options

Job summary

CVS Health in Arizona is seeking a licensed clinician to coordinate utilization/benefit management services for child and adolescent members. You will review medical necessity, document decisions, and collaborate with providers to ensure appropriate care.

The role emphasizes evidence-based practice, clinical judgment, and timely communication, with standard 40-hour work week and occasional travel within the United States.

Qualifications

• 2+ years of behavioral health experience.
• Active and good standing Arizona clinical and/or counseling license (RN/LPC/LAC/LMFT/LMAFT/LMSW/LCSW).
• Willingness to work Monday-Friday from 8am-5pm (Arizona Time), with occasional weekends/holidays.
• Willingness to travel up to 10% within the United States.

Responsibilities

• Coordinate, document, and communicate all aspects of utilization/benefit management.
• Consult and lend expertise to internal and external constituents in coordination of utilization activities.
• Gather clinical information and apply medical necessity criteria to render coverage determinations.
• Coordinate with providers to facilitate optimal care and referrals as needed.

Skills

Behavioral health experience

Communication skills

Time management

Organizational skills

Education

Master’s-level clinician or RN

Job description

CVS Health in Arizona is seeking a licensed clinician to coordinate utilization/benefit management services for child and adolescent members. You will review medical necessity, document decisions, and collaborate with providers to ensure appropriate care.

The role emphasizes evidence-based practice, clinical judgment, and timely communication, with standard 40-hour work week and occasional travel within the United States.