Remote Behavioral Health Utilization Clinician

CVS Health; Central City (NE); Remote; USD 36,000 - 77,000; Full time

Benefits offered by this job

Remote work flexibility

Comprehensive benefits package

Job summary

CVS Health is hiring a Behavioral Health Utilization Management Clinician for remote work with Louisiana preferred. You will review services, apply guidelines, coordinate decisions with care teams, and support discharge planning to improve member outcomes.

Requires an active behavioral health license in Louisiana or a psychiatric RN license, 3+ years clinical experience, and EMR proficiency. Sunday–Thursday 8:00 AM–5:00 PM CST; remote flexibility for weekends/holidays.

Qualifications

• Active, unrestricted behavioral health license in Louisiana (LCSW, LCPC, LMFT, LPCC, LPAT, LPC) or an unrestricted RN license with psychiatric specialty experience.
• 3+ years of behavioral health clinical practice experience in settings such as psychiatric hospital, residential treatment, or behavioral health treatment settings.
• 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 for medical necessity and appropriateness.
• Apply evidence-based guidelines and clinical best practices across levels of care.
• Coordinate 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 programs and services.
• Promote cost-effective, high-quality utilization and outcomes.
• Collaborate with internal and external stakeholders to support care management.

Skills

Behavioral Health license

RN license (psychiatric)

EMR experience

Clinical practice experience

Education

Master's degree

Nursing degree (RN) with psych focus

Tools

EMR systems

Job description

CVS Health is hiring a Behavioral Health Utilization Management Clinician for remote work with Louisiana preferred. You will review services, apply guidelines, coordinate decisions with care teams, and support discharge planning to improve member outcomes.

Requires an active behavioral health license in Louisiana or a psychiatric RN license, 3+ years clinical experience, and EMR proficiency. Sunday–Thursday 8:00 AM–5:00 PM CST; remote flexibility for weekends/holidays.