Clinical Utilization Manager
2 weeks ago
CVS Health is seeking a highly skilled Clinical Utilization Manager to join our team. As a key member of our Behavioral Health department, you will play a critical role in coordinating, documenting, and communicating all aspects of the utilization/benefit management program for preauthorization of mental health services.
Key Responsibilities:
- Utilize clinical skills to coordinate and document all aspects of the utilization/benefit management program.
- Apply critical thinking and knowledge of clinically appropriate treatment, evidence-based care, and clinical practice guidelines for Behavioral Health and/or medical conditions.
- Work in a call center setting, utilizing strong communication and interpersonal skills to interact with patients, families, and healthcare providers.
- Collaborate with cross-functional teams to ensure seamless coordination of care and effective communication of patient information.
Requirements:
- 3+ years of post-clinical licensure experience in Behavioral Health.
- 3+ years of knowledge of mental health and substance abuse disorders.
- Valid unrestricted independent professional Behavioral Health clinical license to practice per state regulations in the state of residence.
- Ability to work in a fast-paced environment, utilizing strong time management and organizational skills.
Preferred Qualifications:
- Direct clinical experience in a hospital setting or prior Utilization Management experience.
Education:
- Bachelor's degree in nursing required with emphasis on Behavioral Health or Psychology (if RN).
- Masters degree in Social Work, Counseling, or Psychology required (if BH-licensed).
Pay Range:
$54,142.576.72
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.
CVS Health offers a comprehensive benefits package, including medical, dental, and vision benefits, 401(k) retirement savings plan, and employee stock purchase plan. Eligible employees may also participate in the Company's term life insurance plan, short-term and long-term disability benefits, and well-being programs.
CVS Health is an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law.
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