Utilization Management Clinician Behavioral Health Swing shift/weekend shift -4 days

Utah, United States

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Not SpecifiedCompensation

Senior (5 to 8 years)Experience Level

Full TimeJob Type

UnknownVisa

Healthcare, PharmaceuticalsIndustries

Requirements

Candidates must possess at least 3 years of post-clinical licensure experience in behavioral health and 3 years of knowledge in mental health and substance abuse disorders. A valid, unrestricted independent professional behavioral health clinical license to practice per state regulations is required, such as LPC, LMFT, LCSW, LMHC, LCMHC, LICSW, LISW, Clinical Psychologist, or RN. If an RN, a Bachelor's degree in nursing with 3 years of behavioral health experience is necessary. If licensed in behavioral health, a Master's degree in Social Work, Counseling, or Psychology is required. Candidates must also have residential broadband internet speeds of at least 25 mbps download and 3 mbps upload, and be able to talk on the telephone while typing.

Responsibilities

The Utilization Management Clinician will utilize clinical skills to coordinate, document, and communicate all aspects of the utilization/benefit management program for preauthorization of mental health services. They will apply critical thinking and demonstrate knowledge of clinically appropriate treatment, evidence-based care, and clinical practice guidelines for behavioral health and/or medical conditions within a call center setting.

Skills

Behavioral Health

Mental Health

Substance Abuse Disorders

Utilization Management

Preauthorization

Clinical Practice Guidelines

Evidence-Based Care

Critical Thinking

LPC

LMFT

LCSW

LMHC

LCMHC

LICSW

LISW

Clinical Psychologist

Hospital Setting

Residential Broadband

Telephone Communication

Typing

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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