Remote Behavioral Health Utilization Clinician

CVS Health; Indiana; Remote; USD 54,000 - 143,000; Full time

Benefits offered by this job

Shift differential 12.5%

Fully remote (US-wide)

Comprehensive benefits package

Job summary

CVS Health is seeking a Behavioral Health Utilization Management Clinician for a 100% remote nationwide role. You will review preauthorization requests, coordinate decisions with providers, and manage crisis situations, applying clinical judgment to ensure timely, appropriate care.

A licensed behavioral health professional with 3+ years of post-licensure experience is required. The schedule includes weekend and weekday shifts with a 12.5% differential.

Qualifications

• Active, unrestricted independent behavioral health 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 effectively manage telephonic and computer-based work simultaneously.
• High-speed residential internet service (minimum 25 Mbps download / 3 Mbps upload).

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

Behavioral health license

Crisis management

Telehealth coordination

Fast-paced environment

Education

Master's degree in Behavioral Health

Bachelor's degree in Nursing

Job description

CVS Health is seeking a Behavioral Health Utilization Management Clinician for a 100% remote nationwide role. You will review preauthorization requests, coordinate decisions with providers, and manage crisis situations, applying clinical judgment to ensure timely, appropriate care.

A licensed behavioral health professional with 3+ years of post-licensure experience is required. The schedule includes weekend and weekday shifts with a 12.5% differential.