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CVS Health UM Clinician - Behavioral Health in Pennsylvania

Job Description

This role is work at home anywhere in the country.Standard business hours Monday-Friday.Applies critical thinking and is knowledgeable of evidence-based treatment and clinical practice guidelines for Behavioral Health, specific to ABA. The majority of time is spent at a desk and on the telephone reviewing precertification/concurrent cases with the treating provider using specific criteria and making decisions to authorize additional services for our members or refer to a physician for a determination. Collaborates with providers/facilities to ensure appropriate planning to meet member needs

Required Qualifications

-Independent Clinical Behavioral Health license (i.e LCSW, LPC, LMFT, LBS) -3+ years of direct clinical practice experience -Position requires proficiency with computer skills which includes navigating multiple systems and keyboarding -Sedentary work involving periods of sitting, talking, listening. -Work requires sitting for extended periods, talking on the telephone and typing into the computer

COVID Requirements

COVID-19 Vaccination Requirement

CVS Health requires its Colleagues in certain positions 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, pregnancy, or religious belief that prevents them from being vaccinated.

  • If you are vaccinated, you are required to have received at least one COVID-19 shot prior to your first day of employment and to provide proof of your vaccination status within the first 30 days of your employment. For the two COVID-19 shot regimen, you will be required to provide proof of your second COVID-19 shot within the first 60 days of your employment. Failure to provide timely proof of your COVID-19 vaccination status will result in the termination of your employment with CVS Health.

  • If you are unable to be fully vaccinated due to disability, medical condition, pregnancy, or religious belief, you will be required to apply for a reasonable accommodation within the first 30 days of your employment in order to remain employed with CVS Health. As a part of this process, you will be required to provide information or documentation about the reason you cannot be vaccinated. If your request for an accommodation is not approved, then your employment may be terminated.

Preferred Qualifications

-Autism/ABA experience preferred -Managed care/utilization review experience preferred -Case Management experience preferred-Crisis intervention skills preferred


An Independent Clinical Behavior Health license (i.e LCSW, LPC) or BCBA certification with license

Business Overview

At Aetna, a CVS Health company, we are joined in a common purpose: helping people on their path to better health. We are working to transform health care through innovations that make quality care more accessible, easier to use, less expensive and patient-focused. Working together and organizing around the individual, we are pioneering a new approach to total health that puts people at the heart.

We are committed to maintaining a diverse and inclusive workplace. CVS Health is an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring or promotion based on race, ethnicity, gender, gender identity, age, disability or protected veteran status. We proudly support and encourage people with military experience (active, veterans, reservists and National Guard) as well as military spouses to apply for CVS Health job opportunities.