Utilization Management Clinician, Behavioral Health – Autism Care Team

CVS Health Careers

. Assess appropriateness of treatment plans for ABA services using evidence-based standards and practice guidelines .

Posted 11/11/2026full-timeRemote • Utah • United StatesMid-LevelSenior💰 $54,095 - $116,760 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in assessing treatment plans for ABA services, coordinating healthcare services, and providing crisis support. Holds a valid independent professional behavioral health clinical license and possesses extensive experience in clinical practice and crisis intervention.

Highest-signal resume keywords

Valid Independent Professional Behavioral Health Clinical License3 Years Direct Clinical Practice Experience2 Years Crisis Intervention ExperienceExperience Working With Clients With Autism DiagnosisMaster's Degree In Behavioral/Mental Health

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Assessment Of Treatment PlansCrisis SupportClinical Criteria ApplicationCoverage DeterminationsDischarge PlanningMember OutreachUtilization ManagementBehavioral Health Clinical PracticeEvidence-Based StandardsReferral Facilitation

Soft Skills

CommunicationCoordinationProblem-SolvingCollaborationEducation

Tools & Technologies

Healthcare Services CoordinationClinical Information GatheringCrisis Intervention Techniques

Certifications & Qualifications

LPCLMFTLCSWLCPCLMHCLCMHCLICSWLISWLBSLBA

Industry Keywords

ABA ServicesManaged CareBehavioral HealthAutism DiagnosisHealthcare ServicesCrisis InterventionOutpatient ClinicAmbulatory CareTreatment PlansQuality Healthcare Services

About the role

Key responsibilities & impact

Assess appropriateness of treatment plans for ABA services using evidence-based standards and practice guidelines
Coordinate, monitor, and evaluate options to facilitate appropriate healthcare services and benefits for members
Provide triage and crisis support
Gather clinical information and apply clinical criteria, policies, procedures, and judgment to render coverage determinations
Provide providers with determinations and recommendations across the continuum of care and facilitate effective discharge planning
Coordinate with providers and other parties to facilitate optimal care and treatment
Identify members at risk for poor outcomes and facilitate referrals to other products, services, and programs
Conduct member outreach to provide resources and education, answer questions, and offer referrals
Identify opportunities to promote quality and effective healthcare services and benefit utilization
Consult with internal and external constituents regarding utilization and benefit management

Requirements

What you’ll need

Valid unrestricted independent professional behavioral health clinical license required in the state of residence; acceptable licenses include LPC, LMFT, LCSW, LCPC, LMHC, LCMHC, LICSW, LISW, LBS, LBA, or Clinical Psychologist
3 years of direct clinical practice experience post master’s degree, such as in a hospital, ambulatory care, or outpatient clinic/facility
2 years of crisis intervention experience
3 years of experience working with clients with an autism diagnosis
Residential broadband service with internet speeds of at least 25 Mbps/3 Mbps
Master's degree in Behavioral/Mental Health or Human Service/Health Services
Preferred: previous managed care experience

Benefits

Comp & perks

Medical coverage
Dental coverage
Vision coverage
Paid time off
Retirement savings options
Wellness programs
Other resources supporting physical, emotional, and financial well-being
Some candidates may be eligible for partial reimbursement of residential broadband service
CVS Health bonus, commission or short-term incentive program in addition to base pay