Autism Care Team Clinician

7 days ago


Harrisburg, Pennsylvania, United States CVS Health Full time
Job Summary

CVS Health is seeking a skilled Clinical Utilization Specialist to join our Autism Care Team. As a key member of our team, you will play a critical role in ensuring that our members receive high-quality, evidence-based care.

Key Responsibilities
  • Utilize clinical expertise to assess the appropriateness of treatment plans for Applied Behavior Analysis (ABA) services and apply evidence-based standards and practice guidelines to treatment where applicable.
  • Coordinate, monitor, and evaluate options to facilitate appropriate healthcare services/benefits for members.
  • Provide triage and crisis support to members in need.
  • Gather clinical information and apply the appropriate clinical criteria/guidelines, policy, procedure, and clinical judgment to render coverage determinations.
  • Collaborate with providers and other parties to facilitate optimal care/treatment for members.
  • Identify members at risk for poor outcomes and facilitate referral opportunities to integrate with other products, services, and/or programs.
  • Outreach to members to provide resources and education, answer questions, and offer referrals for additional services covered by the member's plan.
  • Identify opportunities to promote quality effectiveness of healthcare services and benefit utilization.
Requirements
  • 3 years of direct clinical practice experience post-master's degree, e.g., hospital setting or alternative care setting such as ambulatory care or outpatient clinic/facility.
  • 2 years of crisis intervention experience.
  • 3 years of experience working with clients with an Autism Diagnosis.
  • Valid unrestricted independent professional behavioral health clinical license to practice per state regulations in the state they reside in/one or more or equivalent is required: LBS, LBA, LPC, LMFT, LCSW, LCPC, LMHC, LCMHC, LICSW, LISW, Clinical Psychologist.
  • Required to use a residential broadband service with internet speeds of at least 25 mbps/3mbps in order to ensure sufficient speed to adequately perform work duties.
Preferred Qualifications
  • Previous Managed Care experience.
Education

Master's degree in Behavioral/Mental health or Human Service/Health Services.

Pay Range

The typical pay range for this role is: $60, $129,615.20



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