Behavioral Health Utilization Clinician — Remote

CVS Health; California City (CA); Remote; USD 36,000 - 77,000; Full time

Benefits offered by this job

Remote flexibility

Comprehensive benefits

Performance bonus eligibility

Job summary

CVS Health is seeking a Behavioral Health Utilization Management Clinician to support members remotely. The role requires licensure in Louisiana or a psychiatric RN with relevant experience, 3+ years in behavioral health, and EMR documentation proficiency.

Work Sunday–Thursday 8:00 AM–5:00 PM CST, with occasional weekends/holidays. The position emphasizes evidence-based care and coordination across care teams.

Qualifications

• Active, unrestricted behavioral health license in Louisiana (LCSW, LCPC, LMFT, LPCC, LPAT, LPC) or an active Compact RN license with psychiatric specialty experience.
• 3+ years of behavioral health clinical practice experience in settings such as psychiatric hospital, residential treatment, or behavioral health treatment facilities.
• 1+ year of Electronic Medical Record (EMR) documentation experience.
• Ability to work Sunday–Thursday, 8:00 AM–5:00 PM CST, with flexibility for weekends/holidays.

Responsibilities

• Review behavioral health services and treatment plans to determine medical necessity and appropriateness of care.
• Apply evidence-based guidelines and clinical best practices across multiple levels of care.
• Coordinate and communicate utilization management decisions with providers and care teams.
• Provide triage support and crisis intervention as needed.
• Facilitate discharge planning and transitions of care.
• Identify at-risk members and coordinate referrals to programs and services.
• Promote quality and cost-effective healthcare utilization and positive member outcomes.
• Collaborate with internal and external stakeholders to support comprehensive care management.

Skills

EMR documentation experience

Clinical practice

Communication skills

Education

Master's degree

Tools

EMR systems

Job description

CVS Health is seeking a Behavioral Health Utilization Management Clinician to support members remotely. The role requires licensure in Louisiana or a psychiatric RN with relevant experience, 3+ years in behavioral health, and EMR documentation proficiency.

Work Sunday–Thursday 8:00 AM–5:00 PM CST, with occasional weekends/holidays. The position emphasizes evidence-based care and coordination across care teams.