Remote Behavioral Health Precertification Clinician

CVS Health; Salt Lake City (UT); Remoto; USD 54.000 - 117.000; Tempo pieno

Vantaggi offerti da questo lavoro

Fully remote opportunity

Competitive benefits package

Medical, dental, vision coverage

Paid time off

Descrizione del lavoro

CVS Health is hiring a Behavioral Health Precertification/UM Clinician for a 100% remote role, with a weekday schedule (12:00 PM–8:30 PM EST). You will review behavioral health authorization requests, determine medical necessity, and support appropriate levels of care for inpatient mental health, detoxification services, and substance use rehabilitation programs.

Ideal candidates hold a Master’s-level behavioral health license or an RN with psychiatric/behavioral health experience, plus 1+ year

Competenze

• Active, unrestricted Master's-level Behavioral Health license in the state of residence (LMSW/LCSW/LISW/LPC or equivalent)
• RN with psychiatric/behavioral health experience also acceptable
• 1+ year Behavioral Health Utilization Review or Utilization Management experience
• 3+ years inpatient behavioral health experience in a hospital setting
• Ability to work 12:00 PM – 8:30 PM EST and have strong clinical decision-making skills

Mansioni

• Review behavioral health assessments and clinical documentation to evaluate medical necessity
• Apply evidence-based behavioral health guidelines to authorization decisions
• Coordinate with facilities to obtain additional information when needed
• Document determinations, rationale, and recommendations clearly
• Communicate decisions to providers and internal stakeholders
• Support discharge planning and transitions of care
• Participate in crisis queue coverage and member triage

Conoscenze

Licensed Behavioral Health license

RN with psychiatric/behavioral health

Utilization Management

Inpatient behavioral health

Clinical decision-making

Formazione

Master's in Behavioral Health

ADN with Behavioral Health experience

BSN (preferred)

Descrizione del lavoro

CVS Health is hiring a Behavioral Health Precertification/UM Clinician for a 100% remote role, with a weekday schedule (12:00 PM–8:30 PM EST). You will review behavioral health authorization requests, determine medical necessity, and support appropriate levels of care for inpatient mental health, detoxification services, and substance use rehabilitation programs.

Ideal candidates hold a Master’s-level behavioral health license or an RN with psychiatric/behavioral health experience, plus 1+ year