Remote Behavioral Health Utilization Clinician

CVS Health; Colorado; À distance; USD 36 000 - 77 000; Plein temps

Avantages offerts par ce poste

Remote flexibility

Comprehensive benefits package

Paid time off

Résumé du poste

CVS Health is seeking a Remote Behavioral Health Utilization Management Clinician to support members across the U.S. in a Sunday–Thursday CST schedule.

The role focuses on medical necessity reviews, evidence-based guidelines, and care coordination to ensure appropriate behavioral health services. The position requires an active behavioral health license in Louisiana or a psychiatric RN with experience, plus 3+ years of clinical practice and 1+ year EMR experience.

Qualifications

• Active, unrestricted independent Behavioral Health license in Louisiana (LCSW, LCPC, LMFT, LPCC, LPAT, LPC) or
• Active, unrestricted Compact RN license with psychiatric specialty experience
• 3+ years of behavioral health clinical practice experience (e.g., psychiatric hospital, residential treatment)
• 1+ year of EMR documentation experience
• Ability to work Sunday–Thursday, 8:00 AM–5:00 PM CST, with some weekends/holidays

Responsabilités

• Review behavioral health services and treatment plans to determine medical necessity and appropriateness of care
• 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 quality, cost-effective healthcare utilization and positive member outcomes
• Collaborate with internal and external stakeholders to support comprehensive care management

Connaissances

EMR navigation

Multitasking

Organizational skills

Formation

Master's degree required (BH licensure)

RN with psych specialty (optional)

Outils

EMR systems

Description du poste

CVS Health is seeking a Remote Behavioral Health Utilization Management Clinician to support members across the U.S. in a Sunday–Thursday CST schedule.

The role focuses on medical necessity reviews, evidence-based guidelines, and care coordination to ensure appropriate behavioral health services. The position requires an active behavioral health license in Louisiana or a psychiatric RN with experience, plus 3+ years of clinical practice and 1+ year EMR experience.