CVS Health

Remote/Telecommute

BH UM Clinical Consultant

Posted over 1 month ago

Job Description

Job Description
This is a full-time telework role, but may require occasional travel to the Phoenix, AZ once COVID restrictions are lifted.

Utilizes clinical experience and skills in a collaborative process to assess appropriateness of treatment plans across levels of care, apply evidence based standards and practice guidelines to treatment where appropriate.

- Coordinate, monitor and evaluate options to facilitate appropriate healthcare services/benefits for members.
- Provides triage and crisis support.
- Gathers clinical information and applies the appropriate clinical criteria/guideline, policy, procedure and clinical judgment to render coverage. determination/recommendation along the continuum of care facilitates including effective discharge planning.
- 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.
- Sedentary work involving periods of sitting, talking, listening

Required Qualifications
- Independent Clinical Licensure Required: Licensed Clinical Social Worker (LCSW), Licensed Professional Counselor (LPC), Licensed Marital and Family Therapist (LMFT) or RN with unrestricted Arizona state license
- 3+ years behavioral health clinical practice experience in a hospital, outpatient clinic or residential facility setting required
- Must reside in Arizona.

Preferred Qualifications
- Managed care/Utilization Review experience preferred.
- Position requires proficiency with computer skills which includes navigating multiple systems and keyboarding.

Education
- Associate's Degree required with RN licensure
- Master's degree required with Licensed independent Behavioral Health clinician

Business Overview
At Aetna, a CVS Health company, we are joined in a common purpose: helping people on their path to better health. We are working to transform health care through innovations that make quality care more accessible, easier to use, less expensive and patient-focused. Working together and organizing around the individual, we are pioneering a new approach to total health that puts people at the heart.


We are committed to maintaining a diverse and inclusive workplace. CVS Health is an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring or promotion based on race, ethnicity, gender, gender identity, age, disability or protected veteran status. We proudly support and encourage people with military experience (active, veterans, reservists and National Guard) as well as military spouses to apply for CVS Health job opportunities.

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