Remote Behavioral Health UM Clinician

CVS Health; Kentucky; A distancia; USD 54.000 - 117.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

Fully remote

Competitive benefits

Bonus eligibility

Descripción de la vacante

CVS Health is seeking a Behavioral Health Precertification/UM Clinician for a 100% remote role with a Monday–Friday schedule from 12:00 PM to 8:30 PM EST. You will review behavioral health authorization requests, assess medical necessity, and determine appropriate levels of care, focusing on inpatient mental health, detox, and substance use programs.

Qualified candidates hold an active Behavioral Health license or an RN with psychiatric experience, plus 1+ year UM experience and 3+ years

Formación

• Active, unrestricted Behavioral Health license in the candidate's state (LMSW/LCSW/LISW/LPC or equivalent).
• OR active, unrestricted RN license with psychiatric/behavioral health experience.
• 1+ year of Behavioral Health Utilization Review/UM experience.
• 3+ years inpatient behavioral health in a hospital setting.
• Ability to work 12:00 PM–8:30 PM EST.

Responsabilidades

• Review behavioral health authorization requests and clinical documentation to determine medical necessity and appropriate levels of care.
• Apply evidence-based behavioral health guidelines and clinical practice standards to authorization decisions.
• Coordinate with facilities and providers to obtain additional clinical information as needed.
• Document determinations, rationale, and recommendations thoroughly.
• Support discharge planning and transitions of care and communicate decisions to providers.

Conocimientos

Licensed Behavioral Health

Utilization Management experience

Psychiatric RN experience

Educación

Master's degree in Social Work/Counseling/Psychology

RN with Behavioral Health experience (ADN/BSN)

Descripción del empleo

CVS Health is seeking a Behavioral Health Precertification/UM Clinician for a 100% remote role with a Monday–Friday schedule from 12:00 PM to 8:30 PM EST. You will review behavioral health authorization requests, assess medical necessity, and determine appropriate levels of care, focusing on inpatient mental health, detox, and substance use programs.

Qualified candidates hold an active Behavioral Health license or an RN with psychiatric experience, plus 1+ year UM experience and 3+ years