Behavioral Health Utilization & Care Coordination Consultant

CVS Health; Wyoming; Hybrid; USD 36,000 - 103,000; Full time

Benefits offered by this job

Medical, dental and vision coverage

Paid time off

Retirement savings options

Wellness programs

Job summary

CVS Health in the United States seeks a licensed behavioral health professional to coordinate utilization management, document care, and communicate with care teams to ensure appropriate services are provided.

You will apply clinical judgment to determine medical necessity, render coverage recommendations, and coordinate with providers across settings. The role requires travel up to 10% within the US and is a full-time position aligned with Arizona time zones.

Qualifications

• 2+ years of behavioral health experience.
• Active and good standing Arizona clinical and/or counseling license (RN/LPC/LAC/LMFT/LMAFT/LMSW/LCSW).
• Willingness to work Monday–Friday 8am–5pm (Arizona Time) with occasional weekends/holidays.
• Willingness to travel up to 10% within the United States.

Responsibilities

• Coordinate, document, and communicate all aspects of the utilization/benefit management program.
• Apply clinical judgment to determine medical necessity and render coverage determinations or recommendations.
• Collaborate with providers and other stakeholders to facilitate optimal care and benefits utilization.
• Identify members who may benefit from care management and facilitate referrals.

Skills

Behavioral health experience

Clinical coordination

Communication

Collaboration

Education

Masters-level clinician or RN licensed in AZ

Job description

CVS Health in the United States seeks a licensed behavioral health professional to coordinate utilization management, document care, and communicate with care teams to ensure appropriate services are provided.

You will apply clinical judgment to determine medical necessity, render coverage recommendations, and coordinate with providers across settings. The role requires travel up to 10% within the US and is a full-time position aligned with Arizona time zones.