About the position
The Utilization Management Clinician for Behavioral Health at CVS Health is responsible for coordinating, documenting, and communicating all aspects of the utilization and benefit management program for preauthorization of mental health services. This role requires applying clinical skills and critical thinking in a call center setting, focusing on evidence-based care and clinical practice guidelines for behavioral health and medical conditions. The position operates on a night shift schedule, requiring work on weekends and holidays.
Responsibilities
• Utilize clinical skills to coordinate and document utilization management for mental health services.
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• Communicate effectively with clients and stakeholders regarding preauthorization processes.
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• Apply critical thinking to assess and determine appropriate treatment options based on clinical guidelines.
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• Maintain knowledge of mental health and substance abuse disorders to inform decision-making.
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• Work within a call center environment, managing a queue-based workload.
Requirements
• 3+ years of post-clinical licensure experience in behavioral health.
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• 3+ years of knowledge of mental health and substance abuse disorders.
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• Valid unrestricted independent professional behavioral health clinical license (e.g., LPC, LMFT, LCSW, LMHC, LCMHC, LICSW, LISW, Clinical Psychologist, or RN).
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• Ability to use a residential broadband service with internet speeds of at least 25 mbps/3mbps.
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• Ability to talk on the telephone and type simultaneously.
Nice-to-haves
• Direct clinical experience in a hospital setting.
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• Prior Utilization Management experience.
Benefits
• Medical, dental, and vision benefits.
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• 401(k) retirement savings plan.
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• Employee Stock Purchase Plan.
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• Fully-paid term life insurance.
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• Short-term and long-term disability benefits.
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• Well-being programs.
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• Education assistance and free development courses.
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• CVS store discount and discount programs with partners.
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• Paid Time Off (PTO) and paid holidays.