Clinical Utilization Specialist
4 weeks ago
CVS Health is seeking a skilled Clinical Utilization Specialist to join our team. As a key member of our utilization management team, you will play a critical role in coordinating and documenting all aspects of the utilization/benefit management program for preauthorization of mental health services.
Key Responsibilities
- Utilize clinical skills to coordinate and communicate all aspects of the utilization/benefit management program for preauthorization of mental health services.
- Apply critical thinking and knowledge of clinically appropriate treatment, evidence-based care, and clinical practice guidelines for Behavioral Health and/or medical conditions based upon program focus within a call center setting.
Requirements
- 3+ years of post-RN experience in behavioral health.
- 3+ years of knowledge of mental health and substance abuse disorders.
- Valid unrestricted RN with compact license.
- Required to use a residential broadband service with internet speeds of at least 25 mbps/3mbps to ensure sufficient speed to adequately perform work duties.
Preferred Qualifications
- Direct clinical experience in a hospital setting or prior utilization management experience.
- Education: RN, Bachelor's degree in nursing required with emphasis on Behavioral Health or Psychology.
What We Offer
- Competitive pay range: $54,095.60 - $142,576.72.
- Eligibility for a CVS Health bonus, commission, or short-term incentive program.
- 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.
About CVS Health
CVS Health is a leading healthcare company that puts its heart into caring for its colleagues and communities. We are committed to delivering enhanced human-centric healthcare for a rapidly changing world. Our Heart At Work Behaviors support this purpose, empowering our colleagues to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make healthcare more personal, convenient, and affordable.
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