Remote Behavioral Health Utilization Clinician

CVS Health; Colorado; Remote; USD 54,000 - 143,000; Full time

Benefits offered by this job

Shift differential 12.5%

Job summary

CVS Health is seeking a Behavioral Health Utilization Management Clinician for a fully remote, nationwide role. The position emphasizes reviewing preauthorization requests, applying evidence-based guidelines, and coordinating with providers to ensure appropriate levels of care while supporting positive member outcomes.

A mental health license and 3+ years of post-licensure experience are required. Responsibilities include crisis assessment, risk management, and collaboration with care teams in a

Qualifications

• Active, unrestricted behavioral health clinical license in state of residence, including LPC/LMHC/LCMHC or RN.
• 3+ years post-licensure behavioral health experience.
• 3+ years with mental health and substance use disorders.
• Ability to manage telephonic and computer-based work simultaneously.
• Hospital-based behavioral health experience.
• Utilization Management or Prior Authorization experience.
• Managed Care experience.
• Behavioral Health Clinicians: Master's degree in Social Work, Counseling, or Psychology.
• Registered Nurses: Bachelor's degree in Nursing with emphasis in Behavioral Health or Psychology.
• Fully remote position available anywhere in U.S.; 12.5% shift differential.

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 interventions including escalation for suicide risk.
• 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

Crisis management

Telephonic & computer-based work

Utilization management

Prior authorization

Managed care

License requirements (LPC/LMHC/LCMHC/R

Education

Master's degree in Social Work, Counseling, or Psychology

Bachelor's degree in Nursing with emphasis in Behavioral Health or Psychology

Job description

CVS Health is seeking a Behavioral Health Utilization Management Clinician for a fully remote, nationwide role. The position emphasizes reviewing preauthorization requests, applying evidence-based guidelines, and coordinating with providers to ensure appropriate levels of care while supporting positive member outcomes.

A mental health license and 3+ years of post-licensure experience are required. Responsibilities include crisis assessment, risk management, and collaboration with care teams in a