Behavioral Analysis Utilization Management Consultant

3 days ago

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CVS Health

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Retail • Pharmacy Benefits Management • Health Insurance • Health Care • Pharmacy

10,000+

Description

• Reside in state of Florida, position is 100% remote. • Applies critical thinking and is knowledgeable in clinically appropriate treatment. • Utilizes clinical experience and skills in a collaborative process. • Coordinates, monitors and evaluates options to facilitate appropriate healthcare services. • Gathers clinical information and applies appropriate clinical criteria to render coverage. • Coordinates with providers for optimal care/treatment. • Identifies members at risk for poor outcomes. • Facilitates referral opportunities to integrate with other products. • Consults and lends expertise to others in administration of the utilization function.

Requirements

• Active, current and unrestricted LBA or BCBA in state of Florida. • 3+ years of clinical practice experience. • 2+ years of experience with MS Office Suite applications. • 1+ year(s) of experience with electronic medical records. • Willing and able to provide on-call UM coverage. • Willing and able to work Monday through Friday 8:00am to 5:00pm EST.

Benefits

• Full range of medical, dental, and vision benefits. • 401(k) retirement savings plan available. • Employee Stock Purchase Plan for eligible employees. • Fully-paid term life insurance plan. • Short-term and long-term disability benefits. • Numerous well-being programs. • Education assistance and free development courses. • CVS store discount and discount programs with partners. • Paid Time Off (PTO) and paid holidays throughout the year.