Remote Utilization Management Clinician - Autism Care Team

4062 Aetna Resources, LLC; Utah; Hybrid; USD 54,000 - 117,000; Full time

Benefits offered by this job

Medical, dental, and vision coverage

Paid time off

Retirement savings options

Job summary

CVS Health is hiring a UM Clinician Behavioral Health for a remote, full-time role with standard Monday–Friday hours. The ideal candidate will hold a valid behavioral health license and bring experience in crisis intervention and autism care, serving members across plans.

The position emphasizes collaboration, coverage determinations, and coordinating with providers to optimize care. Applicants should be able to work within Mountain, Pacific, or Arizona time zones.

Qualifications

• Valid unrestricted behavioral health license in state of residence (e.g., LPC, LMFT, LCSW, LCPC, LMHC).
• 3 years of direct clinical practice post-master’s degree.
• 2 years of crisis intervention experience.
• 3 years of experience with clients diagnosed with autism.
• Residential broadband service with speeds of at least 25 Mbps/3 Mbps or reimbursement eligibility.

Responsibilities

• Assess appropriateness of ABA treatment plans and apply evidence-based guidelines.
• Coordinate and evaluate options to facilitate healthcare services/benefits.
• Provide triage and crisis support.
• Render coverage determinations and assist with discharge planning.
• Coordinate with providers to facilitate optimal care.
• Identify members at risk and coordinate referrals to related programs.
• Outreach members to provide resources and referrals for benefits.
• Promote quality and effective utilization of healthcare services.
• Consult with internal and external stakeholders in utilization/benefit management.

Skills

Licensed behavioral health

Crisis intervention

Autism spectrum support

Clinical license

Education

Master's degree in Behavioral/Mental Health or related field

Job description

CVS Health is hiring a UM Clinician Behavioral Health for a remote, full-time role with standard Monday–Friday hours. The ideal candidate will hold a valid behavioral health license and bring experience in crisis intervention and autism care, serving members across plans.

The position emphasizes collaboration, coverage determinations, and coordinating with providers to optimize care. Applicants should be able to work within Mountain, Pacific, or Arizona time zones.