Remote Behavioral Health Utilization Clinician

CVS Health; Central City (NE); Remote; USD 54,000 - 143,000; Full time

Benefits offered by this job

Comprehensive benefits

Remote-first

Bonus eligibility

Job summary

CVS Health is seeking a Behavioral Health Utilization Management Clinician for a fully remote role nationwide. You will review preauthorization requests, applying evidence-based guidelines and clinical judgment to ensure timely behavioral health services.

This 40-hour/week position requires hospital-like responsiveness in a telephonic environment and offers a 12.5% shift differential, with holidays required. A comprehensive benefits package supports colleagues and their families.

Qualifications

• Active, unrestricted behavioral health license in your state.
• 3+ years post-licensure behavioral health experience.
• 3+ years of experience with mental health and substance use disorders.

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.
• Manage crisis calls, assess risk, and coordinate appropriate interventions including escalation for suicide risk or 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

Behavioral health license (LCSW/LPC,等)

Telephonic work multitask

High‑speed internet

Education

Behavioral Health Clinician: Master's in Social Work, Counseling, or Psychology

RN: BSN with Behavioral Health/Psychology focus

Job description

CVS Health is seeking a Behavioral Health Utilization Management Clinician for a fully remote role nationwide. You will review preauthorization requests, applying evidence-based guidelines and clinical judgment to ensure timely behavioral health services.

This 40-hour/week position requires hospital-like responsiveness in a telephonic environment and offers a 12.5% shift differential, with holidays required. A comprehensive benefits package supports colleagues and their families.