Aetna UM Clinician - BH in Sandy, Utah
Req ID: 37686BR
Utilizes clinical skills to coordinate, document and communicate all aspects of the utilization/benefit management program.
Applies critical thinking and is knowledgeable of evidence-based treatment and clinical practice guidelines for Behavioral Health and or medical conditions based upon the program focus. The majority of time is spent at a desk and on the telephone reviewing 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.
3-5 years of direct clinical practice experience post masters degree, e.g., hospital setting or alternative care setting such as ambulatory care or outpatient clinic/facility
Managed care/utilization review experience preferred
Position requires proficiency with computer skills which includes navigating multiple systems and keyboarding
The highest level of education desired for candidates in this position is a Master's degree.
LICENSES AND CERTIFICATIONS
Mental Health/Licensed Professional Counselor (LPC) or Licensed Clinical Social Worker (LCSW) or Marriage & Family Therapist (LMFT) or RN/Psych is required
Clinical / Medical/Concurrent review / discharge planning/1-3 Years
Clinical / Medical/Precertification/1-3 Years
Clinical / Medical/Direct patient care (hospital, private practice)/1-3 Years
Desktop Tools/Microsoft Outlook/1-3 Years/End User
Desktop Tools/Microsoft Word/1-3 Years/End User
General Business/Communicating for Impact/FOUNDATION
General Business/Consulting for Solutions/ADVANCED
General Business/Turning Data into Information/ADVANCED
Leadership/Driving a Culture of Compliance/FOUNDATION
Leadership/Fostering a Global Perspective/FOUNDATION
Full-Time Telework (WAH) unless the candidate is within a reasonable commute to the Sandy office.
ADDITIONAL JOB INFORMATION
Aetna is a stable company with a long history of healthcare experience. We have talented staff and offer multiple benefits to our employees. This position offers an opportunity to improve diagnostic skills and learn more about effective care.
Aetna is about more than just doing a job. This is our opportunity to re-shape healthcare for America and across the globe. We are developing solutions to improve the quality and affordability of healthcare. What we do will benefit generations to come.
We care about each other, our customers and our communities. We are inspired to make a difference, and we are committed to integrity and excellence.
Together we will empower people to live healthier lives.
Aetna is an equal opportunity & affirmative action employer. All qualified applicants will receive consideration for employment regardless of personal characteristics or status. We take affirmative action to recruit, select and develop women, people of color, veterans and individuals with disabilities.
We are a company built on excellence. We have a culture that values growth, achievement and diversity and a workplace where your voice can be heard.
Benefit eligibility may vary by position. Click here to review the benefits associated with this position.
Job Function: Health Care