Remote Behavioral Health Utilization Clinician

CVS Health; Eagle (ID); Remote; USD 54,000 - 143,000; Full time

Benefits offered by this job

Fully remote

Shift differential 12.5%

Competitive benefits

Job summary

CVS Health is seeking a Behavioral Health Utilization Management Clinician for a 100% remote role across the U.S. You will review requests, coordinate decisions, and manage crisis situations with clinical judgment to ensure timely, appropriate behavioral health services.

The role requires active licensure, 3+ years of post-licensure experience, and the ability to work telephonically and via computer with reliable internet.

Qualifications

• Active, unrestricted independent behavioral health license in your state.
• 3+ years post-licensure behavioral health experience.
• Experience handling telephonic and computer-based work.
• High-speed internet (min 25 Mbps download / 3 Mbps upload).
• Ability to manage crisis calls and escalate when needed.

Responsibilities

• Review preauthorization requests for behavioral health services using evidence-based guidelines.
• Coordinate and document utilization management decisions with providers.
• Manage crisis calls and assess risk; coordinate interventions including welfare checks when necessary.
• Apply clinical expertise to support quality and cost-effective care.
• Work in a fast-paced queue-based environment with multiple priorities.
• Collaborate with care teams to ensure appropriate levels of care.

Skills

Behavioral health licensure

Telephonic work

Clinical judgment

Crisis management

Electronic health records

Education

Master's degree in Social Work / Counseling / Psychology

Bachelor's degree in Nursing (if RN role)

Job description

CVS Health is seeking a Behavioral Health Utilization Management Clinician for a 100% remote role across the U.S. You will review requests, coordinate decisions, and manage crisis situations with clinical judgment to ensure timely, appropriate behavioral health services.

The role requires active licensure, 3+ years of post-licensure experience, and the ability to work telephonically and via computer with reliable internet.