Utilization Management Clinical Consultant, ABA Autism Therapy, Kentucky at CVS Health

Overview

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

Location: Kentucky License Required: Independent BH or RN in Kentucky 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.
• Required

Qualifications

• 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 ​ Preferred

Qualifications

• Managed care/utilization review experience preferred Independent BCBA/LBA preferred Education: Master's Level of Education resulting in independent Behavioral Health licensure (LCSW, LPCC, LMFT, LPAT, LP, LBA) or an Associate's degree in Nursing with a KY or compact state Registered Nurse (RN) License with psychiatric specialty or behavioral health experience.
• Anticipated Weekly Hours 40 Time Type Full time Pay Range The typical pay range for this role is: $26.01 - $56.14 This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls.
• The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors.
• This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above.
• Our people fuel our future.
• Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.
• Great

Benefits

• for great people We take pride in offering a comprehensive and competitive mix of pay and

Benefits

• that reflects our commitment to our colleagues and their families. This full‑time position is eligible for a comprehensive

Benefits

• package designed to support the physical, emotional, and financial well‑being of colleagues and their families. The

Benefits

• for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility. Additional details about available

Benefits

• are provided during the application process and on