# Utilization Management Clinician

**Company**: CVS Health
**Location**: LA, LA
**Work arrangement**: remote
**Experience**: senior
**Job type**: full-time
**Salary**: $26.01 - $56.14
**Category**: Healthcare
**Industry**: Healthcare

**Apply**: https://cvshealth.wd1.myworkdayjobs.com/en-US/CVS_Health_Careers/job/LA---Work-from-home/Utilization-Management-Clinical-Consultant_R1016247?utm_source=yubhub.co&utm_medium=jobs_feed&utm_campaign=apply
**Canonical**: https://yubhub.co/job/utilization-management-clinician-3b9d3a13-d82/

## Description

We're building a world of health around every individual , shaping a more connected, convenient, and compassionate health experience.

**Job Summary** As a Utilization Management Clinician, you will utilize clinical skills to coordinate, document, and communicate all aspects of the utilization/benefit management program.

**Key Responsibilities**

- Apply critical thinking and knowledge of clinically appropriate treatment, evidence-based care, and clinical practice guidelines for Behavioral Health and/or medical conditions.

- Assess appropriateness of treatment plans, apply evidence-based standards, and practice guidelines to treatment where appropriate.

- Coordinate, monitor, and evaluate options to facilitate appropriate healthcare services/benefits for members.

- Provide triage and crisis support.

- Gather clinical information and apply clinical criteria/guidelines to render coverage determinations/recommendations.

- Coordinate with providers and other parties to facilitate optimal care/treatment.

- Identify members at risk for poor outcomes and facilitate referral opportunities.

- Identify opportunities to promote quality effectiveness of healthcare services and benefit utilization.

**Requirements**

- Licensed independent Behavioral Health clinician (LCSW, LCPC, LMFT, LPCC, LPAT, LPC) in Louisiana or a Registered Nurse (RN) with unrestricted compact state license with psychiatric specialty experience.

- 3 years of clinical practice experience in a psychiatric hospital, residential, or behavioral health treatment setting.

- 1 year of Electronic Medical Record documentation experience.

- Must be able to work Monday through Friday, 8:00 AM to 5:00 PM CST with flexibility to work outside of the standard schedule.

**Preferred Qualifications**

- Reside in Louisiana.

- Managed care/utilization review experience.

- Experience in a behavioral health inpatient setting.

- Ability to multitask, prioritize, and adapt to a fast-paced environment.

- Proficiency with computer skills, including navigating multiple systems and keyboarding.

- LAC (Licensed Addiction Counselor) preferred.

**Benefits**

- Comprehensive benefits package, including medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources.

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## Skills

### Required
- Behavioral Health
- Clinical Practice Guidelines
- Electronic Medical Record
- Psychiatric Specialty

### Nice to have
- Managed Care
- Utilization Review
- LAC (Licensed Addiction Counselor)

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Source: [Apply at cvshealth.wd1.myworkdayjobs.com](https://cvshealth.wd1.myworkdayjobs.com/en-US/CVS_Health_Careers/job/LA---Work-from-home/Utilization-Management-Clinical-Consultant_R1016247?utm_source=yubhub.co&utm_medium=jobs_feed&utm_campaign=apply)