ABA UM Clinical Consultant

CVS Health

2d • $26 - $56 • Remote

About The Position

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Position Summary: Applies critical thinking and is knowledgeable in clinically appropriate treatment, evidence-based care and clinical practice guidelines for Behavioral Health, specific to ABA. Utilizes clinical experience and skills in a collaborative process to assess appropriateness of treatment plans across levels of care, applying evidence-based standards and practice guidelines to treatment where appropriate. Coordinate, monitor and evaluate options to facilitate appropriate healthcare services/benefits for members. Gathers clinical information and applies the appropriate clinical criteria/guideline, policy, procedure and clinical judgment to render coverage. Coordinates with providers and other parties to facilitate optimal care/treatment. Identifies members at risk for poor outcomes and facilitates referral opportunities to integrate with other products, services and/or programs. Identifies opportunities to promote quality effectiveness of healthcare services and benefit utilization. Consults and lends expertise to other internal and external constituents in the coordination and administration of the utilization/benefit management function. This is a remote position.

Requirements

• Licensed independent behavioral health clinician with KY licensure (LCSW, LPCC, LMFT, LPAT, LP, LBA) or a Registered Nurse (RN) with a KY or compact license with psychiatric specialty or behavioral health experience.
• 3+ years clinical practice experience, e.g., hospital setting, direct clinical practice experience required
• Autism treatment/ABA experience required
• Ability to multitask, prioritize and effectively adapt to a fast-paced changing environment
• Position requires proficiency with computer skills which includes navigating multiple systems and keyboarding
• Schedule is Monday-Friday, 8:00am-5:00pm EST with flexibility to work outside of the standard schedule based on business needs

Nice To Haves

• Managed care/utilization review experience preferred
• Independent BCBA/LBA preferred

Benefits

• Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.
• No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.
• Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level