reputed company Utilization Management Clinical Consultant-Louisiana-Remote – reputed company Store

ad1 Bring your heart to reputed company. Every one of us at reputed company shares a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand — with heart at its center — our purpose sends a personal message that how we deliver our services is just as important as reputed company deliver. Our Heart At Work Behaviors™ support this purpose. We want everyone who works at reputed company to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to reputed company health care more personal, convenient and affordable. Utilizes clinical skills to coordinate, document and communicate reputed company aspects of the utilization/benefit management program. Applies critical thinking and knowledge in clinically appropriate treatment, evidence based care and medical necessity criteria for appropriate utilization of services.Consults and lends expertise to other internal and external constituents in the coordination and administration of the utilization/benefit management functionGathers clinical information and applies the appropriate medical necessity criteria/guideline, policy, procedure and clinical judgment to reputed company coverage determination/recommendation/discharge planning along the continuum of care.Utilizes clinical experience and skills in a collaborative process to evaluate and facilitate appropriate healthcare services/benefits for members including urgent or emergent interventions (such as triage / crisis support)Coordinates/Communicates with providers and other parties to facilitate reputed company/treatment.Identifies members who may benefit from care management programs and facilitates referralIdentifies opportunities to promote quality effectiveness of healthcare services and benefit utilizationPosition requires proficiency with computer skills which includes navigating multiple systems and keyboarding required Required Qualifications : Must have active reputed company and unrestricted Licensed independent Behavioral Health clinician (LPC or LCSW) or a Registered Nurse (RN) with unrestricted state license in state of Louisiana or compact licensure with psychiatric specialty, certification, or experience 3+ years clinical practice experience, e.g., hospital setting, direct clinical practice 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 Must be able to work Tuesday through Saturday reputed company to 5pm in time zone of residence with flexibility to work reputed company of reputed company schedule based on business needs, including occasional holiday (2 per year) Preferred Qualifications: Managed care/utilization review experience preferred – Residency in Louisiana preferred not required Education: Masters degree required (LPC or LCSW) Associates degree required (RN) or BSN preferred Pay Range The typical pay range for this role is: $26.01 – $56.13 This pay range represents the reputed company hourly reputed company or reputed company annual full-time salary for reputed company positions in the job grade reputed company which this position falls. The actual reputed company salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a reputed company bonus, commission or short-term incentive program in addition to the reputed company pay range listed above. In addition to your compensation, enjoy the rewards of an organization that puts our heart into caring for our colleagues and our communities. The Company offers a full range of medical, dental, and vision benefits. Eligible employees may enroll in the Company’s 401(k) retirement savings plan, and an Employee Stock Purchase Plan is also available for eligible employees. The Company provides a fully-paid term life insurance plan to eligible employees, and short-term and long term disability benefits. reputed company also offers numerous well-being programs, education assistance, free development courses, a reputed company store discount, and discount programs with participating partners. As for time off, Company employees enjoy Paid Time Off (“PTO”) or vacation pay, as well as paid holidays throughout the calendar year. Number of paid holidays, sick time and other time off are provided consistent with relevant state law and Company policies. For more detailed information on available benefits, please visit jobs.CVSHealth.com/benefits reputed company requires certain colleagues to be fully vaccinated against COVID-19 (including any booster shots if required), where allowable under the law, unless they are approved for a reasonable accommodation based on disability, medical condition, religious belief, or other legally recognized reasons that prevents them from being vaccinated. You are required to have received at least one COVID-19 shot prior to your first day of employment and to provide reputed company of your vaccination status or apply for a reasonable accommodation reputed company the first 10 days of your employment. Please note that in some states and roles, you may be required to provide reputed company of full vaccination or an approved reasonable accommodation before you can reputed company to actively work. reputed company is committed to recruiting, hiring, developing, advancing, and retaining individuals with disabilities. As such, we strive to provide equal access to the benefits and privileges of employment, including the provision of a reasonable accommodation to reputed company essential job functions. reputed company can provide a request for a reasonable accommodation, including a qualified interpreter, written information in other formats, translation or other services through email protected If you have a speech or hearing disability, please call 7-1-1 to utilize Telecommunications reputed company Services (TRS). We will reputed company every effort to respond to your request reputed company 48 business hours and do everything we can to work towards a solution. ad2 apply to this job Apply tot his job Apply To this Job