Remote Behavioral Health Utilization Clinician

CVS Health; Clayton (NM); Remote; USD 36,000 - 77,000; Full time

Benefits offered by this job

Remote work flexibility

Job summary

CVS Health is seeking a Behavioral Health Utilization Management Clinician for a remote role with a Louisiana preference. The position supports utilization management for behavioral health services, requiring licensure and 3+ years of clinical experience, with EMR proficiency and CST work hours.

Responsibilities include medical necessity reviews, applying guidelines, coordinating with care teams, crisis triage, and discharge planning.

Qualifications

• Active, unrestricted Behavioral Health license in Louisiana or an unrestricted psychiatric RN license
• 3+ years of behavioral health clinical practice experience
• 1+ year of Electronic Medical Record (EMR) documentation experience
• Ability to work Sunday-Thursday, 8:00 AM - 5:00 PM CST
• Louisiana residency strongly preferred (preferred)

Responsibilities

• Review behavioral health services to determine medical necessity and appropriateness of care
• Apply evidence-based guidelines across multiple levels of care
• Coordinate utilization 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
• 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

RN license (psychiatric)

3+ years clinical practice

EMR documentation

Sunday-Thursday CST

Education

Master's degree in Behavioral Health

BSN or RN with psych experience

Job description

CVS Health is seeking a Behavioral Health Utilization Management Clinician for a remote role with a Louisiana preference. The position supports utilization management for behavioral health services, requiring licensure and 3+ years of clinical experience, with EMR proficiency and CST work hours.

Responsibilities include medical necessity reviews, applying guidelines, coordinating with care teams, crisis triage, and discharge planning.