Remote Behavioral Health UM Clinician | 12.5% Shift Diff

CVS Health; Pennsylvania; Teletrabalho; USD 54 000 - 143 000; Tempo integral

Vantagens oferecidas por esta oferta de emprego

Shift differential 12.5%

Comprehensive benefits package

Remote-friendly position

Resumo da oferta

CVS Health is seeking a Behavioral Health Utilization Management Clinician for a 100% remote, nationwide role. You will review preauthorization requests, coordinate decisions, and support risk assessment and care coordination for behavioral health members.

The position requires an active behavioral health license, 3+ years post-licensure experience, and experience with utilization management or prior authorization.

Qualificações

• Active, unrestricted behavioral health license in state of residence (LBHP, LMHC, LPC, LCMHC or RN)
• 3+ years post-licensure behavioral health experience
• 3+ years working with mental health and substance use disorders
• Ability to manage telephonic and computer-based work simultaneously
• Experience in Utilization Management or Prior Authorization
• Hospital-based behavioral health experience a plus

Responsabilidades

• Review preauthorization requests for behavioral health services using guidelines and clinical judgment
• Coordinate, document, and communicate utilization management decisions with providers
• Manage crisis calls and assess risk with appropriate interventions
• Apply clinical expertise to support quality and cost-effective care
• Work in a fast-paced queue-based environment with multiple priorities
• Collaborate with care teams to facilitate appropriate levels of care

Conhecimentos

Telephonic work capability

Clinical judgment

Crisis management

Care coordination

Fast-paced / queue-based work

Formação académica

Master's degree in Social Work, Counseling, or Psychology

Bachelor's degree in Nursing with emphasis in Behavioral Health or Psychology

Ferramentas

Utilization Management / Prior Authorization experience

Managed Care experience

Descrição da oferta de emprego

CVS Health is seeking a Behavioral Health Utilization Management Clinician for a 100% remote, nationwide role. You will review preauthorization requests, coordinate decisions, and support risk assessment and care coordination for behavioral health members.

The position requires an active behavioral health license, 3+ years post-licensure experience, and experience with utilization management or prior authorization.