Clinical Utilization Consultant - Behavioral Health

CVS Health; Austin (TX); On-site; USD 36,000 - 77,000; Full time

Benefits offered by this job

Bonus eligibility

Job summary

CVS Health is seeking a licensed behavioral health clinician or psychiatric RN to coordinate utilization and benefit management for members. You will apply evidence-based guidelines to assess treatment plans and collaborate with providers to ensure optimal care and appropriate services.

The role emphasizes crisis triage, risk identification and referral opportunities, with a focus on quality, compliance, and program efficiency within a fast-paced environment.

Qualifications

• Licensed independent Behavioral Health clinician (LCSW, LCPC, LMFT, LPCC, LPAT, LPC) or RN with psychiatric specialty.
• 3 years clinical practice in behavioral health or related setting.
• 1 year EMR documentation experience.

Responsibilities

• Coordinate, document and communicate utilization/benefit management activities.
• Assess appropriateness of treatment plans across levels of care using clinical guidelines.
• Coordinate with providers to facilitate optimal care and benefits.
• Identify at-risk members and coordinate referrals to integrate with services.
• Lend clinical expertise to internal and external stakeholders.

Skills

Behavioral Health licensure

RN with psychiatric specialty

Clinical judgment

Education

Master's in Behavioral Health or related field

Job description

CVS Health is seeking a licensed behavioral health clinician or psychiatric RN to coordinate utilization and benefit management for members. You will apply evidence-based guidelines to assess treatment plans and collaborate with providers to ensure optimal care and appropriate services.

The role emphasizes crisis triage, risk identification and referral opportunities, with a focus on quality, compliance, and program efficiency within a fast-paced environment.