Remote Behavioral Health Utilization Clinician

CVS Health; Georgia; Remote; USD 54,000 - 116,000; Full time

Benefits offered by this job

Comprehensive benefits

Remote-friendly

Job summary

CVS Health is seeking a Behavioral Health Utilization Management Clinician to support evidence-based care from a remote location. The role focuses on reviewing treatment plans, determining medical necessity, and coordinating with care teams to ensure optimal outcomes for members.

Flexibility for occasional weekends is required, with a Sunday–Thursday schedule in CST. Ideal candidates hold an active Behavioral Health license in Louisiana or a compact RN license with psychiatric experience, plus

Qualifications

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

Responsibilities

• Review behavioral health services and treatment plans to determine medical necessity.
• Apply evidence-based guidelines across levels of care.
• Coordinate utilization 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.
• Promote cost-effective utilization and positive outcomes.
• Collaborate with stakeholders to support comprehensive care management.

Skills

Strong multitasking

Prioritization

Organizational skills

Education

Master's degree required for independently licensed Behavioral Health clinicians

Registered Nurse with psychiatric specialty experience and unrestricted nursing license (Bachelors Degree in Nursing)

Tools

EMR documentation

Job description

CVS Health is seeking a Behavioral Health Utilization Management Clinician to support evidence-based care from a remote location. The role focuses on reviewing treatment plans, determining medical necessity, and coordinating with care teams to ensure optimal outcomes for members.

Flexibility for occasional weekends is required, with a Sunday–Thursday schedule in CST. Ideal candidates hold an active Behavioral Health license in Louisiana or a compact RN license with psychiatric experience, plus