Remote Behavioral Health Utilization Clinician

CVS Health; Kentucky; 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 Behavioral Health Utilization Management Clinician for a 100% remote, nationwide role. You will review preauthorization requests, coordinate decisions, and support crisis interventions while collaborating with providers and care teams to ensure appropriate levels of care.

This full-time role offers a shift differential and requires an active behavioral health license with 3+ years of post-licensure experience in behavioral health, including mental health and substance use

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 effectively manage telephonic and computer-based work simultaneously.
• Fully remote position available anywhere in the U. S.

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 Behavioral Health Pro

Crisis management

Telephonic work

Documentation & coordination

Prior Authorization experience

Education

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

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, and support crisis interventions while collaborating with providers and care teams to ensure appropriate levels of care.

This full-time role offers a shift differential and requires an active behavioral health license with 3+ years of post-licensure experience in behavioral health, including mental health and substance use