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CVS Health UM Clinician - BH in WORK FROM HOME, Florida

Job Description

Qualifying candidates may be eligible for a sign on bonus of up to $5,000This is a full-time telework role. Schedule is Monday-Friday, standard business hours. Monitor clinical care services provided to members related to mental health and substance abuse treatment to optimize clinical outcomes. Provide telephone triage, crisis intervention and emergency authorizations as assigned. Provide information to members and providers regarding mental health and substance abuse benefits, community treatment resources, mental health managed care programs, and Aetna Behavioral Health policies and procedures, and criteria. Interact with Physician Advisors to discuss clinical/authorization questions and concerns regarding specific cases. Participate in QI activities including data collection, tracking, and analysis.

Required Qualifications

  • 3+ years post degree experience in a psychiatric or substance abuse setting required- Applicant must be licensed in their home state as either a LSW, LCSW, LMSW, LMFT, LMCH, RN or LPC.

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

  • 3+ years experience in managed care


  • Master's degree or Doctoral degree required with behavioral licensure) LSW, LCSW, LMSW, LMFT, LMCH or LPC.- Associate's degree or nursing diploma required with RN licensure - Meets requirements for independent professional practice per state regulations including current active license without encumbrances.

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.