Behavioral Health Utilization Management Clinical Consultant - Work at Home - Oklahoma at CVS Health

Tulsa, Oklahoma, United States

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Not SpecifiedCompensation

Mid-level (3 to 4 years)Experience Level

Full TimeJob Type

UnknownVisa

HealthcareIndustries

Requirements

Unrestricted OK state independent Behavioral Health clinician license (LCSW, LCPC, LMFT, LPAT, LP) or Registered Nurse (RN) with psychiatric specialty, certification, or Behavioral Health experience
Master's Level of Education resulting in independent Behavioral Health licensure (LCSW, LPCC, LMFT, LPAT, LP) or RN with unrestricted state license with psychiatric specialty, certification, or experience
3+ years clinical practice experience (e.g., psychiatric hospital, residential or behavioral health treatment setting)
1+ year Electronic Medical Record documentation experience
Experience in a psychiatric or behavioral health setting
Strong knowledge of clinical practice guidelines and utilization management
Proficiency with computer skills, including navigating multiple systems and keyboarding
Reliable High Speed internet access
Ability to multitask, prioritize, and adapt to a fast-paced changing environment
Schedule: Monday-Friday with flexibility for business needs, including occasional rotating weekend and holiday schedules

Responsibilities

Evaluate treatment plans using clinical judgment and evidence-based standards
Coordinate and monitor healthcare services to ensure optimal benefit utilization
Provide triage and crisis support for members in need
Facilitate effective discharge planning and care transitions
Collaborate with providers and internal teams to support integrated care
Identify at-risk members and connect them with appropriate resources
Promote quality and cost-effective care through clinical consultation and review

Skills

LCSW

LCPC

Behavioral Health

Utilization Management

Psychiatric Care

Clinical Guidelines

Treatment Plan Evaluation

Crisis Support

Discharge Planning

CVS Health

Comprehensive pharmacy and healthcare services

About CVS Health

CVS Health operates a large network of retail pharmacies and walk-in medical clinics across the United States, providing a variety of health-related products and services. Their offerings include prescription medications, over-the-counter health products, and beauty items, as well as pharmacy benefits management and specialty pharmacy services. CVS Health's integrated business model allows them to serve individual consumers, businesses, and communities effectively, with a focus on improving health outcomes and reducing healthcare costs. Unlike many competitors, CVS Health combines pharmacy services with medical care, making it easier for patients to access quality healthcare. The company's goal is to enhance access to healthcare and support individuals in achieving better health.

Woonsocket, Rhode IslandHeadquarters

1963Year Founded

DEBTCompany Stage

Healthcare, Consumer GoodsIndustries

10,001+Employees

Benefits

Health Insurance

Dental Insurance

Vision Insurance

Life Insurance

Disability Insurance

401(k) Retirement Plan

Company Equity

Wellness Program

Professional Development Budget

Paid Vacation

Paid Holidays

Risks

Legal challenges related to opioid prescriptions could harm CVS's reputation and finances.

The DOJ's intervention in a whistleblower lawsuit may increase legal costs for CVS.

The Horizon Organic Milk recall exposes potential vulnerabilities in CVS's supply chain.

Differentiation

CVS Health operates over 9,600 retail pharmacies and 1,100 walk-in clinics nationwide.

The company integrates pharmacy benefits management with specialty pharmacy services for comprehensive care.

CVS Health offers tailored medication plans through personalized medicine and pharmacogenomics.

Upsides

Expansion of telehealth services allows CVS to reach more patients remotely.

Increased consumer interest in wellness boosts demand for CVS's health-related products.

The trend towards value-based care aligns with CVS's integrated healthcare approach.

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