Remote Behavioral Health Utilization Clinician

CVS Health; Hydaburg (AK); Remote; USD 54,000 - 143,000; Full time

Benefits offered by this job

Remote work

Shift differential 12.5%

Job summary

CVS Health is seeking a licensed behavioral health professional for a fully remote Utilization Management Clinician role, serving members nationwide. This position emphasizes clinical decision-making, care coordination, and timely authorization decisions to support quality outcomes.

You’ll review requests, coordinate with providers, and manage crisis and risk with escalation as needed. A strong telehealth workflow and commitment to safety underpin the role.

Qualifications

• Active, unrestricted behavioral health clinical license in your state.
• 3+ years post-licensure behavioral health experience.
• Experience with telephonic and computer-based work.

Responsibilities

• Review preauthorization requests for behavioral health services using guidelines and clinical judgment.
• Coordinate and communicate utilization management decisions with providers and stakeholders.
• Manage crisis calls, assess risk, and escalate 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

Behavioral health license

Telephonic coordination

Clinical decision making

Crisis management

Education

Master's degree in Social Work, Counseling, or Psychology

Bachelor's degree in Nursing with Behavioral Health emphasis or Psychology

Job description

CVS Health is seeking a licensed behavioral health professional for a fully remote Utilization Management Clinician role, serving members nationwide. This position emphasizes clinical decision-making, care coordination, and timely authorization decisions to support quality outcomes.

You’ll review requests, coordinate with providers, and manage crisis and risk with escalation as needed. A strong telehealth workflow and commitment to safety underpin the role.