Remote Behavioral Health Utilization Clinician

CVS Health; Alabama; Remote; USD 54,000 - 143,000; Full time

Benefits offered by this job

Remote work (100% national)

Shift differential 12.5%

Job summary

CVS Health is seeking a licensed Behavioral Health professional for a 100% remote Utilization Management Clinician role. You will review preauthorization requests for behavioral health services and coordinate management decisions with providers and care teams.

The role requires active unrestricted license (e.g., LPC/LMHC/LCMHC or RN with BH emphasis), 3+ years post-licensure BH experience, and UM or prior authorization experience, with telephonic and computer-based work.

Qualifications

• Active, unrestricted independent behavioral health license in your state of residence (e.g., LPC, LMHC, LCMHC)
• Master's degree in Social Work, Counseling, or Psychology
• 3+ years of post-licensure behavioral health experience
• 3+ years of experience with mental health and substance use disorders
• Experience with Utilization Management or Prior Authorization

Responsibilities

• Review preauthorization requests for behavioral health services using evidence-based guidelines and clinical judgment
• Coordinate, document, and communicate utilization management decisions with providers and stakeholders
• Ability to manage crisis calls and assess risk, including escalation for suicide risk and welfare checks
• Apply clinical expertise to support quality, cost-effective care and positive member outcomes
• Work in a fast-paced, queue-based environment while managing multiple priorities
• Collaborate with providers and care teams to facilitate appropriate levels of care

Skills

Telephonic work

Clinical judgment

Care coordination

Evidence-based guidelines

Team collaboration

Crisis management

Education

Master's degree in Social Work, Counseling, or Psychology

Active behavioral health license

RN with behavioral health emphasis (optional)

Job description

CVS Health is seeking a licensed Behavioral Health professional for a 100% remote Utilization Management Clinician role. You will review preauthorization requests for behavioral health services and coordinate management decisions with providers and care teams.

The role requires active unrestricted license (e.g., LPC/LMHC/LCMHC or RN with BH emphasis), 3+ years post-licensure BH experience, and UM or prior authorization experience, with telephonic and computer-based work.