Behavioral Health Utilization Clinician

CVS Health; New Jersey; Hybrid; USD 36,000 - 103,000; Full time

Benefits offered by this job

Bonus eligibility

Benefits package

Job summary

CVS Health is seeking a clinician to coordinate and document all aspects of utilization/benefit management. The role applies evidence-based criteria to determine medical necessity and supports care coordination across the continuum.

The position requires 2+ years in behavioral health, an active clinical license in Arizona, and willingness to work standard hours with some travel. A comprehensive benefits package and bonus eligibility are provided.

Qualifications

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

Responsibilities

• Utilizes clinical skills to coordinate, document, and communicate all aspects of the utilization/benefit management program.
• Applies clinical judgment to render coverage determinations/recommendations along the continuum of care.
• Identifies members who may benefit from care management and facilitates referrals.
• Coordinates with providers to facilitate optimal care and service utilization.

Skills

Behavioral health experience

Communication skills

Organization

Time management

Travel flexibility

Education

Master's degree / RN license

Job description

CVS Health is seeking a clinician to coordinate and document all aspects of utilization/benefit management. The role applies evidence-based criteria to determine medical necessity and supports care coordination across the continuum.

The position requires 2+ years in behavioral health, an active clinical license in Arizona, and willingness to work standard hours with some travel. A comprehensive benefits package and bonus eligibility are provided.