Behavioral Health Utilization Clinician

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

Benefits offered by this job

Bonus eligibility

Medical, dental, vision coverage

Paid time off

Job summary

CVS Health is seeking a qualified behavioral health professional to coordinate utilization/benefit management for child and adolescent members. The role emphasizes evidence-based care, clinical judgment, and collaboration with providers to ensure appropriate coverage determinations and discharge planning.

You will work a Monday–Friday schedule in Arizona time, with occasional weekend/holiday coverage and up to 10% travel across the United States.

Qualifications

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

Responsibilities

• Coordinate, document, and communicate all aspects of the utilization/benefit management program.
• Apply clinical judgement and criteria for medical necessity for appropriate utilization of services.
• Consult with internal and external stakeholders in managing utilization/benefit operations.
• Identify members who may benefit from care management and facilitate referrals.
• Collaborate with providers to coordinate care and promote quality outcomes.

Skills

Behavioral health experience

Communication skills

Organizational skills

Time management

Collaborative approach

Education

Masters-level clinician

RN license (AZ)

Job description

CVS Health is seeking a qualified behavioral health professional to coordinate utilization/benefit management for child and adolescent members. The role emphasizes evidence-based care, clinical judgment, and collaboration with providers to ensure appropriate coverage determinations and discharge planning.

You will work a Monday–Friday schedule in Arizona time, with occasional weekend/holiday coverage and up to 10% travel across the United States.