Remote Behavioral Health Utilization Clinician

CVS Health; Butlerville (IN); Remote; USD 54,000 - 143,000; Full time

Benefits offered by this job

Remote work

Shift differential 12.5%

Job summary

CVS Health is hiring a Behavioral Health Utilization Management Clinician for a 100% remote role nationwide. You will review preauthorization requests, coordinate decisions with providers, manage crisis calls, and support cost-effective, quality behavioral health care.

Requires an active, unrestricted behavioral health license and 3+ years of post-licensure experience in mental health and substance use disorders. A 12.5% shift differential applies; holidays may be required.

Qualifications

• Active, unrestricted independent behavioral health clinical license in your state of residence, including one of: LCSW, LICSW, LISW, LMSW; LPC, LMHC, LCMHC; LMFT; Clinical Psychologist; RN.
• 3+ years of post-licensure behavioral health experience.
• 3+ years of experience working with mental health and substance use disorders.
• Ability to effectively manage telephonic and computer-based work simultaneously.
• High-speed residential internet service (minimum 25 Mbps download / 3 Mbps upload).

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, apply clinical judgment to assess risk, determine support needs, and coordinate appropriate interventions, including escalation for suicide risk, self-harm concerns, and welfare checks when necessary.
• 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.

Education

Master's degree in Behavioral Health (Social Work / Counseling / Psychology)

Bachelor's degree in Nursing (Behavioral Health or Psychology emphasis)

Job description

CVS Health is hiring a Behavioral Health Utilization Management Clinician for a 100% remote role nationwide. You will review preauthorization requests, coordinate decisions with providers, manage crisis calls, and support cost-effective, quality behavioral health care.

Requires an active, unrestricted behavioral health license and 3+ years of post-licensure experience in mental health and substance use disorders. A 12.5% shift differential applies; holidays may be required.