At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care.As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues - caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day.Location: Remote (Arizona residents only)
Travel: Occasional travel up to 10% to Phoenix, AZ
Schedule: Monday-Friday, standard business hours (Arizona time)
Additional Coverage: Rotational coverage during holidays and weekends may be required.Position Summary
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Are you passionate about making a meaningful difference in the lives of children and adolescents? Join Mercy Care as a Behavioral Health Utilization Management Clinician and become part of a mission-driven team that's transforming healthcare for Arizona's most vulnerable populations.In this full-time, remote role, you'll apply your clinical expertise to ensure members receive the right care at the right time. You'll use evidence-based guidelines and medical necessity criteria to guide utilization and benefit decisions, helping young members access the behavioral health services they need to thrive.What sets this opportunity apart is the supportive, tight-knit team culture-many of our clinicians have been with us for years and genuinely enjoy the work they do and the people they do it with. You'll benefit from flexible scheduling, a collaborative environment, and the chance to make a lasting impact on the lives of children across Arizona.If you're looking for a role where your clinical skills are valued, your voice is heard, and your work truly matters, Mercy Care is the place for you.Key Responsibilities
- Review clinical information and apply medical necessity criteria to make coverage determinations and discharge planning decisions.
- Collaborate with providers and internal teams to ensure timely, appropriate healthcare services.
- Provide urgent or emergent interventions, including triage and crisis support.
- Identify members for care management programs and facilitate referrals.
- Promote quality and cost-effective utilization of healthcare services.
- Support internal and external stakeholders with clinical expertise and guidance.
- Primarily a desk-based role that involves focused periods of communication and collaboration through virtual platforms, offering a comfortable and structured work environment.
- Fully remote with occasional travel to Phoenix, AZ (up to 10%).
- This is a 100% remote role; candidates must have a dedicated workspace free of interruptions.
- Dependents must have separate care arrangements during work hours, as continuous care responsibilities during shift times are not permitted.
- Must reside in the state of Arizona.
- Active Arizona licensure in one of the following:
- Licensed Clinical Social Worker (LCSW)
- Licensed Professional Counselor (LPC)
- Licensed Marriage and Family Therapist (LMFT)
- Registered Nurse (RN)
- Associate-level licenses may be considered based on relevant experience.
- Minimum of 2 years of behavioral health experience.
- Experience with Arizona Department of Child Safety (DCS).
- Knowledge of Behavioral Health Outpatient Services.
- Utilization Management (UM) Experience.
- Master's degree required for behavioral health clinicians (LCSW, LPC, LMFT).
- Associate's degree required for RN applicants.
40Time Type
Full timePay Range
The typical pay range for this role is:$29.10 - $62.32This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above.Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.Great benefits for great peopleWe take pride in our comprehensive and competitive mix of pay and benefits - investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:
- Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.
- No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.
- Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.