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Aetna UM Clinician - BH in Encinitas, California

Req ID: 60102BR

Job Description

Full time work from home. Preference to those in Mountain or Pacific standard time.


The Aetna Autism Care Team works within an integrated team to perform utilization review, as well as proactive discharge planning. This includes working in close collaboration with our business partners, as well as the enterprise to promote overall wellness for our members. A license to practice in the state in which you live is required.

Fundamental Components included but are not limited to:

Applies critical thinking and is knowledgeable of evidence-based treatment and clinical practice guidelines for Behavioral Health. The majority of time is spent at a desk and on telephonic or records review of precertification/concurrent/retrospective cases with the treating provider/records using specific criteria and making decisions to authorize services for our members OR refer to a physician for a determination. These clinicians also collaborate with providers/facilities to ensure appropriate planning to meet member needs.

Qualifications Requirements and Preferences:

Behavioral Health licensure required

3+ years clinical experience post-Master's degree required

Experience with children is a requirement

Autism experience is highly preferred

Utilization review experience preferred

Managed care experience preferred

Crisis intervention skills preferred

Position requires proficiency with computer skills which includes navigating multiple systems and keyboarding

Sedentary work involving periods of sitting, talking, listening. Work requires sitting for extended periods, talking on the telephone and typing into the computer


The minimum level of education desired for candidates in this position is a Bachelor's degree or equivalent experience.


Mental Health/Licensed Clinical Social Worker

Mental Health/Licensed Professional Counselor

Nursing/Registered Nurse

Mental Health/Licensed Psychologist

Additional Job Information:

This is an opportunity to be part of a high performing dynamic team while enjoying the flexibility of working from home.

Benefit Eligibility

Benefit eligibility may vary by position. Click here to review the benefits associated with this position.

Job Function: Health Care

Aetna is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected Veterans status.