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CVS Health - Denver, CO

posted 2 months ago

Full-time - Mid Level
Remote - Denver, CO
Health and Personal Care Retailers

About the position

The Utilization Management Clinician RN for Behavioral Health at CVS Health is responsible for coordinating, documenting, and communicating all aspects of the utilization and benefit management program for preauthorization of mental health services. This fully remote position requires critical thinking and knowledge of clinically appropriate treatment and evidence-based care within a call center setting. The role involves working night shifts, including weekends and holidays, to ensure comprehensive support for mental health services.

Responsibilities

  • Utilize clinical skills to coordinate and document utilization management for mental health services.
  • Communicate effectively with clients and healthcare providers regarding preauthorization processes.
  • Apply critical thinking to assess and determine appropriate treatment options based on clinical guidelines.
  • Maintain knowledge of mental health and substance abuse disorders to provide informed support.
  • Work within a call center environment, managing a queue-based workload.

Requirements

  • 3+ years of post-RN experience in behavioral health.
  • 3+ years of knowledge in mental health and substance abuse disorders.
  • Valid unrestricted RN license with compact license.
  • Ability to use a residential broadband service with internet speeds of at least 25 mbps/3mbps.
  • Proficient in multitasking, specifically talking on the phone while typing.

Nice-to-haves

  • Direct clinical experience in a hospital setting.
  • Prior Utilization Management experience.

Benefits

  • Medical, dental, and vision benefits.
  • 401(k) retirement savings plan.
  • Employee Stock Purchase Plan.
  • Fully-paid term life insurance.
  • Short-term and long-term disability benefits.
  • Well-being programs and education assistance.
  • Free development courses.
  • CVS store discount and discount programs with partners.
  • Paid Time Off (PTO) and paid holidays.
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