Remote Behavioral Health Utilization Clinician

CVS Health; Alton (IL); Remote; USD 36,000 - 77,000; Full time

Benefits offered by this job

Comprehensive benefits package

Remote work

Bonus eligibility

Job summary

CVS Health seeks a licensed Behavioral Health Utilization Management Clinician to support members remotely in Louisiana. Review services for medical necessity, coordinate with care teams, and apply evidence-based care to ensure quality and cost-effectiveness.

Require 3+ years’ behavioral health experience, Louisiana licensure, EMR experience, and a Master’s degree for independent licensure. Remote role with occasional weekends/holidays.

Qualifications

• Active, unrestricted Behavioral Health license in Louisiana (LCSW, LCPC, LMFT, LPCC, LPAT, LPC) or an unrestricted Compact RN license with psychiatric specialty experience.
• Master's degree required for independently licensed Behavioral Health clinicians.

Responsibilities

• Review behavioral health services and treatment plans to determine medical necessity and appropriateness of care.
• Coordinate and communicate utilization management decisions with providers and care teams.
• Provide triage support and crisis intervention as needed.
• Facilitate discharge planning and transitions of care.
• Identify at-risk members and coordinate referrals to additional programs.

Skills

Behavioral health license

RN license with psychiatric specialty

EMR experience

Utilization management

Crisis intervention

Discharge planning

Education

Master's degree in Behavioral Health or related field

Bachelor’s in Nursing (optional alternative)

Tools

EMR systems

Job description

CVS Health seeks a licensed Behavioral Health Utilization Management Clinician to support members remotely in Louisiana. Review services for medical necessity, coordinate with care teams, and apply evidence-based care to ensure quality and cost-effectiveness.

Require 3+ years’ behavioral health experience, Louisiana licensure, EMR experience, and a Master’s degree for independent licensure. Remote role with occasional weekends/holidays.