Utilization Management Clinician - Behavioral Health

Hispanic Alliance for Career Enhancement; Utah; Remote; USD 54,000 - 117,000; Full time

Job summary

A leading healthcare organization is seeking a qualified professional for a fully remote role focused on clinical assessments and treatment planning. Candidates must have substantial clinical experience and an independent behavioral health license. This position offers a salary range between $54,095.00 and $116,760.00, with comprehensive benefits.

Benefits

Affordable medical plan options

401(k) plan with matching contributions

No-cost wellness programs

Qualifications

• 3+ years of direct clinical practice experience post masters degree.
• Unencumbered Independent Behavioral Health clinical license.

Responsibilities

• Utilizes clinical experience to assess treatment plans.
• Provides triage and crisis support.
• Coordinates with providers to facilitate optimal care.

Skills

Direct clinical practice experience

Crisis intervention skills

Knowledge of mental health and substance abuse disorders

Managed care/utilization review experience

Proficiency with computer skills

Education

Masters Degree in behavioral health profession

RN license (requires Bachelor's Degree)

Job description

At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care.

As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues - caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day.

Position Summary

• Fully remote in the USA.
• Utilizes clinical experience, and skills, in a collaborative process to assess appropriateness of treatment plans across levels of care, apply evidence based standards and practice guidelines to treatment where appropriate. Coordinate, monitor and evaluate options to facilitate appropriate healthcare services/benefits for members.
• Provides triage and crisis support.
• Gathers clinical information and applies the appropriate clinical criteria/guideline, policy, procedure and clinical judgment to render coverage determination/recommendation along the continuum of care facilitates including effective discharge planning.
• Coordinates with providers and other parties to facilitate optimal care/treatment.
• Identifies members at risk for poor outcomes and facilitates referral opportunities to integrate with other products, services and/or programs
• Identifies opportunities to promote quality effectiveness of healthcare services and benefit utilization
• Consults and lends expertise to other internal and external constituents in the coordination and administration of the utilization/benefit management functions.
• Must be able to talk on the telephone and type at the same time, this has some queue based work involved
• Candidate must be available to work within the hours of Monday- Friday 10am-8:30pm EST. No holidays and no weekends.

Required Qualifications

• 3+ years of direct clinical practice experience post masters degree, e.g., hospital setting or alternative care setting such as ambulatory care or outpatient clinic/facility.
• Unencumbered Independent Behavioral Health clinical license in the state where they work. Must have one of the following or equivalent: (LPC, LPCC, LMHCS, LMHC, LMFT, LCSW) OR RN with 3+ years of clinical behavioral health experience required.

Preferred Qualifications

• Knowledge of mental health and substance abuse disorders
• Managed care/utilization review experience
• Crisis intervention skills
• Position requires proficiency with computer skills which includes navigating multiple systems and keyboarding
• Sedentary work involving periods of sitting, talking, listening. Work requires sitting for extended periods, talking on the telephone and typing into the computer

Education

Masters Degree in behavioral health profession

RN license must have a Bachelors Degree

Anticipated Weekly Hours

40

Time Type

Full time

Pay Range

The typical pay range for this role is: $54,095.00 - $116,760.00

This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above.

Benefits

We take pride in our comprehensive and competitive mix of pay and benefits - investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:

• Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.
• No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.
• Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.

CVS Health is an equal opportunity employer. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.