Remote Behavioral Health Utilization Clinician

CVS Health; East Windsor Hill (CT); Remote; USD 54,000 - 143,000; Full time

Benefits offered by this job

Fully remote

Shift differential 12.5%

Job summary

CVS Health is seeking a Behavioral Health Utilization Management Clinician for a fully remote, nationwide role. You will review preauthorizations, coordinate decisions with providers, and manage crisis situations while applying clinical judgment to ensure quality, cost-efficient care.

A strong behavioral health license and 3+ years of post-licensure experience are required. Position offers a 40-hour week, 12.5% shift differential, and the chance to impact members across the U.S.

Qualifications

• Active, unrestricted independent behavioral health license in your state.
• Licenses: LCSW, LICSW, LISW, LMSW; LPC, LMHC, LCMHC; LMFT; Clinical Psychologist; RN.
• 3+ years post-licensure behavioral health experience.
• 3+ years of experience with mental health and substance use disorders.
• Ability to manage telephonic and computer-based work simultaneously.
• High-speed internet (minimum 25 Mbps download / 3 Mbps upload).

Responsibilities

• Review preauthorization requests for behavioral health services using guidelines and clinical judgment.
• Coordinate, document, and communicate utilization management decisions with providers and stakeholders.
• Manage crisis calls, assess risk, and coordinate appropriate interventions including escalation for suicide risk when necessary.
• Apply clinical expertise to support quality and 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

Independent clinical license

Telephonic work

Crisis management

Clinical judgment

Evidence-based guidelines

Education

Master's in Social Work

Master's in Counseling

Master's in Psychology

Bachelor's in Nursing (Behavioral Health/Psychology)

Job description

CVS Health is seeking a Behavioral Health Utilization Management Clinician for a fully remote, nationwide role. You will review preauthorizations, coordinate decisions with providers, and manage crisis situations while applying clinical judgment to ensure quality, cost-efficient care.

A strong behavioral health license and 3+ years of post-licensure experience are required. Position offers a 40-hour week, 12.5% shift differential, and the chance to impact members across the U.S.