Remote Behavioral Health Utilization Clinician

CVS Health; Arkansas; Remote; USD 36,000 - 77,000; Full time

Benefits offered by this job

Remote work flexibility

Great benefits

Job summary

CVS Health is seeking a Behavioral Health Utilization Management Clinician for a remote role with a Louisiana preference. You will review services, apply guidelines, and coordinate utilization decisions to support quality, evidence-based care and efficient transitions.

The role requires an active Behavioral Health license in Louisiana or a psychiatric RN with CST schedule Sunday–Thursday, 8:00 AM–5:00 PM, CST, plus 3+ years of clinical practice and 1+ year EMR experience.

Qualifications

• Active, unrestricted Behavioral Health license in Louisiana (LCSW, LCPC, LMFT, LPCC, LPAT, LPC)
• Active, unrestricted Compact RN license with psychiatric specialty experience
• 3+ years of behavioral health clinical practice
• 1+ year of EMR documentation experience
• Ability to work Sunday - Thursday, 8:00 AM - 5:00 PM CST, with flexibility for weekends/holidays

Responsibilities

• Review behavioral health services and treatment plans to determine medical necessity and appropriateness of care
• Apply evidence-based guidelines and clinical best practices across multiple levels of care
• Coordinate and communicate utilization management decisions with providers and care teams
• Provide triage support and crisis intervention as needed
• Facilitate effective discharge planning and transitions of care
• Identify members at risk for poor outcomes and coordinate referrals to additional programs and services
• Promote quality, cost-effective healthcare utilization and positive member outcomes
• Collaborate with internal and external stakeholders to support comprehensive care management

Skills

Behavioral Health license (Louisiana)

RN license with psychiatric specialty

3+ years behavioral health clinical

EMR documentation experience

Sunday–Thursday CST schedule ability

Education

Master's degree in Behavioral Health (required)

RN with psych experience (considered)

Tools

EMR systems

Job description

CVS Health is seeking a Behavioral Health Utilization Management Clinician for a remote role with a Louisiana preference. You will review services, apply guidelines, and coordinate utilization decisions to support quality, evidence-based care and efficient transitions.

The role requires an active Behavioral Health license in Louisiana or a psychiatric RN with CST schedule Sunday–Thursday, 8:00 AM–5:00 PM, CST, plus 3+ years of clinical practice and 1+ year EMR experience.