Skip to main content

Behavioral Health Utilization Management Clinician (LPC, LCSW, LMFT)

Primary Location: Phoenix, AZ
Additional Locations: AZ-Phoenix
Apply
Description:
This role is office based in Phoenix, AZ.
Standard business hours are required Monday-Friday.


Utilizes clinical skills to coordinate, document and communicate all aspects of the utilization/benefit management program. Applies critical thinking and is knowledgeable in clinically appropriate treatment, evidence based care and clinical practice guidelines for Behavioral Health and/or medical conditions based upon program focus.

Fundamental Components:
- Utilizes clinical experience and skills in a collaborative process to assess appropriateness of treatment plans across levels of care, apply evidence based standards and practice guidelines to treatment where appropriate.
- Coordinate, monitor and evaluate options to facilitate appropriate healthcare services/benefits for members.
- Provides triage and crisis support.
- Gathers clinical information and applies the appropriate clinical criteria/guideline, policy, procedure and clinical judgment to render coverage. determination/recommendation along the continuum of care facilitates including effective discharge planning.
- Coordinates with providers and other parties to facilitate optimal care/treatment.
- Identifies members at risk for poor outcomes and facilitates referral opportunities to integrate with other products, services and/or programs.
- Identifies opportunities to promote quality effectiveness of healthcare services and benefit utilization.
- Consults and lends expertise to other internal and external constituents in the coordination and administration of the utilization/benefit management function.

Background Experience:
- Unencumbered Independent Behavioral Health clinical license for Arizona required (i.e. LPC, LCSW, LMFT)
- 3+ years of direct clinical practice experience required
- Crisis intervention skills preferred
- Managed care/utilization review experience preferred
- Minimum of a Master's degree in Behavioral/Mental health or Human Service/Health Services required
- Work requires sitting for extended periods, talking on the telephone and typing into the computer
- Sedentary work involving periods of sitting, talking, listening
- Position requires proficiency with computer skills which includes navigating multiple systems and keyboarding

Additional Job Information:
Typical office working environment with productivity and quality expectations. Work requires the ability to perform close inspection of hand written and computer generated documents as well as a PC monitor.Sedentary work involving periods of sitting, talking, listening. Work requires sitting for extended periods, talking on the telephone and typing on the computer.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


Functional Skills:
Medical Management - Medical Management - Concurrent Review

Technology Experience:
Desktop Tool - Microsoft Outlook, Desktop Tool - Microsoft Word, Desktop Tool - TE Microsoft Excel

Education:
Mental Health - Licensed Clinical Social Worker, Mental Health - Licensed Professional Counselor

Potential Telework Position:
No

Percent of Travel Required:
0 - 10%

EEO Statement:
Aetna is an Equal Opportunity, Affirmative Action Employer

Benefit Eligibility:
Benefit eligibility may vary by position.

Candidate Privacy Information:
Aetna takes our candidate's data privacy seriously. At no time will any Aetna recruiter or employee request any financial or personal information (Social Security Number, Credit card information for direct deposit, etc.) from you via e-mail. Any requests for information will be discussed prior and will be conducted through a secure website provided by the recruiter. Should you be asked for such information, please notify us immediately.

Apply

Jobs for you

Recently Viewed Jobs

You do not have any recently viewed jobs

Your Saved Jobs

You do not have any saved jobs

Sign up for Job Alerts

Join our Talent Community

At Aetna, a CVS Health Company, we are pioneering a total approach to health and wellness and we need talented candidates like you to join our team. Become a member of our talent community to be the first to know about career initiatives that match your skills and interests as they become available, in addition to details on upcoming events, networking opportunities, and news about Aetna, a CVS Health Company.

Join Our Talent Community

Sign up to receive information about job openings that are tailored to your skills and interests. Plus, get the latest career news from Aetna, a CVS Health Company.