Remote Behavioral Health UM Clinician

CVS Health; New Mexico; A distancia; USD 54.000 - 117.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

Fully remote opportunity

Consistent weekday schedule

Specialized Behavioral Health UM role

Competitive benefits

Descripción de la vacante

CVS Health is hiring a Behavioral Health Precertification/Utilization Management Clinician for a fully remote, weekday role. You will review authorization requests and clinical docs to ensure medical necessity and appropriate levels of care, focusing on inpatient mental health, detox, and substance use rehab.

The ideal candidate is a licensed Behavioral Health clinician or Psychiatric RN with UM experience, available to work 12:00 PM – 8:30 PM EST, and comfortable navigating multiple clinical

Formación

• Active, unrestricted Master’s-level Behavioral Health license (LMSW/LCSW/LISW/LPC or equivalent) in the state of residence.
• OR active, unrestricted RN license with psychiatric/behavioral health experience.
• 1+ year of Behavioral Health Utilization Review or Utilization Management experience.
• 3+ years of inpatient behavioral health experience in a hospital setting.
• Ability to work the scheduled hours 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 to authorization decisions.
• Coordinate with facilities and providers to obtain additional clinical information when needed.
• Support discharge planning and transitions of care.

Conocimientos

Behavioral Health Utilization Review

Utilization Management

Clinical decision-making

Documentation skills

Educación

Master's degree in Behavioral Health

Descripción del empleo

CVS Health is hiring a Behavioral Health Precertification/Utilization Management Clinician for a fully remote, weekday role. You will review authorization requests and clinical docs to ensure medical necessity and appropriate levels of care, focusing on inpatient mental health, detox, and substance use rehab.

The ideal candidate is a licensed Behavioral Health clinician or Psychiatric RN with UM experience, available to work 12:00 PM – 8:30 PM EST, and comfortable navigating multiple clinical