Utilization Management – Registered Nurse or Behavioral Health Clinician - After Hours

CVS Health

1d • 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 This is an after hours work at home position. Must work the below schedule. Schedule: Thursday and Friday 3pm-1am MT Saturday and Sunday 11am-9pm MT Must be able to work Holidays. There will be a 12.5% differential for this shift. Utilizes clinical skills to coordinate, document and communicate all aspects of the utilization/benefit management program for preauthorization for mental health services. Applies critical thinking and is knowledgeable in 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 clinical licensure experience in behavioral health
• 3+ years knowledge of mental health and substance abuse disorders
• 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: LPC, LMFT, LCSW, LMHC, LCMHC, LICSW, LISW, Clinical Psychologist or RN)
• 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.
• Must be able to talk on the telephone and type at the same time, this is a queue based job

Nice To Haves

• Direct clinical experience in a hospital setting or prior Utilization Management experience.

Responsibilities

• Utilizes clinical skills to coordinate, document and communicate all aspects of the utilization/benefit management program for preauthorization for mental health services.
• Applies critical thinking and is knowledgeable in 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.

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