Remote Behavioral Health Utilization Clinician

CVS Health; Guin (AL); Remote; USD 54,000 - 143,000; Full time

Benefits offered by this job

Remote work

Shift differential

Job summary

CVS Health is seeking a Behavioral Health Utilization Management Clinician for a 100% remote role. You will review preauthorization requests, coordinate decisions with providers, and manage crisis calls while ensuring safe, effective care.

The position emphasizes utilization management in behavioral health across a nationwide remote team. The role requires an active behavioral health license, 3+ years of post-licensure experience, and knowledge of managed care.

Qualifications

• Active, unrestricted behavioral health clinical license in your state of residence.
• 3+ years of post-licensure behavioral health experience.
• Experience with mental health and substance use disorders.
• Utilization Management or Prior Authorization experience.

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, assess risk, and coordinate appropriate interventions including suicide risk 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

Behavioral health license

Post-licensure experience

Mental health & substance use

Telephonic & computer-based work

Utilization Management experience

Managed Care experience

Remote work readiness

Education

MSW/MA in Behavioral Health

RN with Behavioral Health emphasis

Job description

CVS Health is seeking a Behavioral Health Utilization Management Clinician for a 100% remote role. You will review preauthorization requests, coordinate decisions with providers, and manage crisis calls while ensuring safe, effective care.

The position emphasizes utilization management in behavioral health across a nationwide remote team. The role requires an active behavioral health license, 3+ years of post-licensure experience, and knowledge of managed care.