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Clinical Utilization Specialist Behavioral Health

2 months ago

Sandy, United States CVS Health Full time
Job Summary

CVS Health is seeking a skilled Clinical Utilization Specialist to join our team. As a key member of our Behavioral Health team, you will play a critical role in coordinating, documenting, and communicating all aspects of our utilization/benefit management program.

Key Responsibilities

* Utilize clinical skills 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
* Provide triage and crisis report, gathering clinical information and applying clinical judgment to render coverage determination/recommendation

Requirements

* 3+ years of behavioral health clinical experience in a hospital setting
* Active current and unrestricted Master's Level Behavioral Health clinical license in the state of residence (LMSW, LCSW, LISW, LPC, or comparable) or Registered Nurse licensure with psychiatric specialty, certification, or experience in state of residence
* Ability to work Monday through Friday 12pm to 8:30pm EST

Preferred Qualifications

* MST or PST zone hours preferred
* Proficiency with computer skills, including navigating multiple systems and keyboarding
* Experience working with geriatric population
* Crisis intervention skills preferred
* Managed care preferred

What We Offer

* Competitive pay range: $60,522.80 - $129,615.20
* Comprehensive benefits package, including medical, dental, and vision benefits
* 401(k) retirement savings plan and Employee Stock Purchase Plan
* Fully-paid term life insurance plan and short-term and long-term disability benefits
* Paid Time Off (PTO) and paid holidays throughout the calendar year

At CVS Health, we are committed to delivering enhanced human-centric healthcare for a rapidly changing world. Our purpose guides our commitment to delivering high-quality care and services to our members. If you are a motivated and detail-oriented professional with a passion for behavioral health, we encourage you to apply for this exciting opportunity.