Utilization Management Clinician | Care Coordination Pro

Careerwebsite; Northern (KY); Hybrid; USD 36,000 - 103,000; Full time

Benefits offered by this job

Medical, dental, vision coverage

Bonus program

Paid time off

Job summary

CVS Health is seeking a full-time Utilization Management clinician to coordinate and document care across the benefit management program in a clinically guided, patient-focused role.

The role requires 2+ years in utilization management with an active Arizona license (RN or licensed behavioral health professional). Hybrid collaboration and travel to Phoenix-related sites may be involved, with a standard 40-hour work week and competitive benefits.

Qualifications

• 2+ years of clinical/utilization management experience.
• Active Arizona clinical license (RN, LPC, LAC, LMFT, LMAFT, LMSW or LCSW).
• Ability to work Monday-Friday 8am-5pm Arizona Time; occasional weekends/holidays as needed.
• Travel up to 10% within Phoenix, AZ.

Responsibilities

• Coordinate, document, and communicate utilization/benefit management activities.
• Apply medical necessity criteria for care determinations and recommendations.
• Lend clinical expertise to internal/external stakeholders.
• Collect clinical information to determine appropriate services and discharge planning.
• Collaborate with providers and care teams to optimize treatment.
• Identify members who may benefit from care management and referrals.

Skills

Utilization management

Clinical coordination

Documentation

Communication

Team collaboration

Education

Master's-level clinician or RN

Tools

Microsoft Office Suite (Word, Excel)

Job description

CVS Health is seeking a full-time Utilization Management clinician to coordinate and document care across the benefit management program in a clinically guided, patient-focused role.

The role requires 2+ years in utilization management with an active Arizona license (RN or licensed behavioral health professional). Hybrid collaboration and travel to Phoenix-related sites may be involved, with a standard 40-hour work week and competitive benefits.