Behavioral Health Utilization Consultant

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

Job summary

CVS Health is seeking a clinician to coordinate utilization/benefit management in a behavioral health context. The role emphasizes applying evidence-based criteria, documenting care, and communicating with providers and care teams across the continuum of care.

Requires 2+ years of behavioral health experience and an active AZ license (RN, LPC, LAC, LMFT, LMAFT, LMSW or LCSW). Travel up to 10% and availability for standard 8–5 Arizona hours are expected.

Qualifications

• 2+ years of behavioral health experience.
• Active and good standing Arizona clinical and/or counseling license (RN, LPC, LAC, LMFT, LMAFT, LMSW or LCSW).
• Willingness to work Monday–Friday 8am–5pm (Arizona Time) and 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 guidelines for services.
• Consult with internal and external stakeholders on utilization/benefit management.
• Facilitate referrals and care management activities across the continuum of care.

Skills

Behavioral health experience

Communication skills

Time management

Travel readiness

Education

Masters-level clinician / RN

Job description

CVS Health is seeking a clinician to coordinate utilization/benefit management in a behavioral health context. The role emphasizes applying evidence-based criteria, documenting care, and communicating with providers and care teams across the continuum of care.

Requires 2+ years of behavioral health experience and an active AZ license (RN, LPC, LAC, LMFT, LMAFT, LMSW or LCSW). Travel up to 10% and availability for standard 8–5 Arizona hours are expected.