Remote Behavioral Health Utilization Clinician

CVS Health; Kentucky; Remote; USD 54,000 - 117,000; Full time

Job summary

CVS Health is seeking a Behavioral Health Utilization Management Clinician for a remote role with a Louisiana preference. The position requires active behavioral health licensure in Louisiana or a compact RN with psychiatric experience and a minimum of three years in behavioral health clinical practice.

You will review services for medical necessity, apply guidelines, coordinate decisions with care teams, and support discharge planning while maintaining timely, evidence-based care for members.

Qualifications

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

Responsibilities

• Review behavioral health services and treatment plans to determine medical necessity and appropriateness of care.
• Apply evidence-based guidelines and clinical best practices across levels of care.
• Coordinate and communicate utilization management 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 additional programs and services.
• Promote quality, cost-effective healthcare utilization and positive member outcomes.
• Collaborate with internal and external stakeholders to support comprehensive care management.

Skills

Active behavioral health license (LA)

EMR experience

3+ years clinical practice

Sunday-Thursday schedule

Education

Master's degree required

RN with psych specialty considered

Tools

EMR systems

Job description

CVS Health is seeking a Behavioral Health Utilization Management Clinician for a remote role with a Louisiana preference. The position requires active behavioral health licensure in Louisiana or a compact RN with psychiatric experience and a minimum of three years in behavioral health clinical practice.

You will review services for medical necessity, apply guidelines, coordinate decisions with care teams, and support discharge planning while maintaining timely, evidence-based care for members.