CVS Health Hiring for Behavioral Health Care Planner- Remote US at Nevada Full Time

• Provide service to clinical teams in support of optimal

care.

• Generates administrative and medical necessity denial

letters, checking for accuracy and appropriateness.

• Makes calls to providers and utilization reviewers to

provide results of medical necessity determinations and

provides specifics for next steps.

• Schedules and coordinates appointments between

providers or attending physicians and Aetna Medical

Directors or Consultants.

• Collects and provides necessary material for

appointments. Calculates deadlines for appointments

and monitor cases for timely return.

• Complies with state mandated and Aetna regulations by

monitoring documentation, checks for nuances before

action taken and follows varying protocols by case or

situation.

Pay Range
The typical pay range for this role is:
Minimum: 19.50
Maximum: 40.10

Please keep in mind that this range represents the pay range for all positions in the job grade within which this position falls. The actual salary offer will take into account a wide range of factors, including location.

Required Qualifications

• 1-3 years experience in health insurance field
• 1-3 years Administrative/ Secretarial experience
• 1-3 years Customer service experience within health care or a mental health capacity

• 60-70 WPM

Preferred Qualifications

• 1-3 years Behavioral Health experience working with the

mental health population preferred.

• Strong communication skills, written and verbal
• Understands psych/med terminology
• Multi-tasking
• Must have complex organizational skills
• Strong typing ability
• Ability to work independently
• Understands plan benefit structures

Education

• Associates degree

Business Overview
Bring your heart to CVS Health Every one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand — with heart at its center — our purpose sends a personal message that how we deliver our services is just as important as what we deliver. Our Heart At Work Behaviors™ support this purpose. We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable. We strive to promote and sustain a culture of diversity, inclusion and belonging every day. CVS Health is an affirmative action employer, and is an equal opportunity employer, as are the physician-owned businesses for which CVS Health provides management services. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law. We proudly support and encourage people with military experience (active, veterans, reservists and National Guard) as well as military spouses to apply for CVS Health job opportunities.