Clinical Utilization & Care Coordination Consultant

CVS Health Corporation; Rhode Island; Hybrid; USD 36,000 - 103,000; Full time

Job summary

CVS Health is seeking a clinically skilled professional to coordinate, document, and communicate all aspects of the utilization/benefit management program. The role applies evidence-based criteria and medical necessity guidelines to render coverage determinations and support care planning across the continuum for members, including urgent or crisis situations.

The position requires 2+ years in a clinical or behavioral health utilization management setting and an active Arizona license (RN, LPC,

Job description

CVS Health is seeking a clinically skilled professional to coordinate, document, and communicate all aspects of the utilization/benefit management program. The role applies evidence-based criteria and medical necessity guidelines to render coverage determinations and support care planning across the continuum for members, including urgent or crisis situations.

The position requires 2+ years in a clinical or behavioral health utilization management setting and an active Arizona license (RN, LPC,