Remote Behavioral Health Utilization Clinician

CVS Health; Elm (PA); Remote; USD 54,000 - 143,000; Full time

Benefits offered by this job

Shift differential

Remote work

Holiday eligibility

Bonus potential

Job summary

CVS Health is seeking a Behavioral Health Utilization Management Clinician for a 100% remote, nationwide role. You will review preauthorization requests, document decisions, and coordinate with providers to ensure timely, appropriate behavioral health services while supporting member outcomes.

The role requires an active, unrestricted BH license in your state, 3+ years of post-licensure BH experience, and experience with crisis assessment and telephonic/work-based workflows.

Qualifications

• Active, unrestricted independent behavioral health clinical license in your state of residence.
• 3+ years of post-licensure behavioral health experience.
• 3+ years of experience working with mental health and substance use disorders.
• Ability to manage telephonic and computer-based work simultaneously.

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 appropriate interventions, including escalation for suicide risk, self-harm concerns, and welfare checks when necessary.
• 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

Licensed BH professional

Crisis management

Telephonic work

Utilization management

Collaboration with providers

Education

Master's in Social Work/Counseling/Psychology

BSN with Behavioral Health/Psychology emphasis

Job description

CVS Health is seeking a Behavioral Health Utilization Management Clinician for a 100% remote, nationwide role. You will review preauthorization requests, document decisions, and coordinate with providers to ensure timely, appropriate behavioral health services while supporting member outcomes.

The role requires an active, unrestricted BH license in your state, 3+ years of post-licensure BH experience, and experience with crisis assessment and telephonic/work-based workflows.