Clinical Utilization & Care Management Consultant

CVS Health; Louisiana (MO); Hybrid; USD 36,000 - 77,000; Full time

Benefits offered by this job

Medical insurance

Dental & Vision

Paid time off

Retirement savings

Wellness program

Job summary

CVS Health in Missouri seeks a licensed behavioral health clinician to coordinate utilization/benefit management, document care, and communicate effectively across care teams to support member outcomes.

Requires Louisiana licensure or RN with psychiatric specialty, 3 years clinical experience, 1 year EMR, and 40-hour work week CST with occasional weekend coverage. Competitive benefits accompany the role.

Qualifications

• Licensed independent Behavioral Health clinician (Louisiana) or RN with psychiatric specialty.
• 3 years clinical practice experience in behavioral health settings.
• 1 year EMR documentation experience.
• Availability for 8:00 AM–5:00 PM CST, Monday–Friday with occasional weekend/holiday coverage.

Responsibilities

• Coordinate, document and communicate all aspects of utilization/benefit management.
• Apply evidence-based care and guidelines for Behavioral Health and/or medical conditions.
• Assess appropriateness of treatment plans across levels of care and facilitate appropriate services.
• Provide triage and crisis support and coordinate with providers to improve care.

Skills

Clinical coordination

Critical thinking

Team collaboration

Communication skills

Education

Master's level education with independent licensure

Tools

EMR software

Job description

CVS Health in Missouri seeks a licensed behavioral health clinician to coordinate utilization/benefit management, document care, and communicate effectively across care teams to support member outcomes.

Requires Louisiana licensure or RN with psychiatric specialty, 3 years clinical experience, 1 year EMR, and 40-hour work week CST with occasional weekend coverage. Competitive benefits accompany the role.