Remote Behavioral Health Utilization Clinician

CVS Health; Lorida (FL); Remote; USD 36,000 - 77,000; Full time

Benefits offered by this job

Comprehensive benefits package

Paid time off

Wellness programs

Job summary

CVS Health seeks a Behavioral Health Utilization Management Clinician to support members’ mental health outcomes. You will review services for medical necessity, coordinate with care teams, and provide crisis intervention as needed.

The role is remote with Louisiana preferred and CST hours (Sun-Thurs, 8:00 AM–5:00 PM CST). A Master’s degree is required for independently licensed clinicians, with 3+ years of clinical experience and EMR proficiency.

Qualifications

• Active, unrestricted behavioral health license in Louisiana or RN with psychiatric specialization.
• 3+ years of behavioral health clinical practice experience.
• Ability to work Sunday–Thursday, 8:00 AM–5:00 PM CST with occasional weekends/holidays.
• Experience with utilization management and care coordination.

Responsibilities

• Review behavioral health services to determine medical necessity and appropriateness of care.
• Coordinate 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 programs and services.
• Promote quality, cost-effective utilization and positive outcomes.
• Collaborate with stakeholders to support comprehensive care management.

Skills

Behavioral health

Utilization management

Crisis intervention

EMR documentation

Communication with providers

Education

Master's degree

Bachelor’s Degree in Nursing

Tools

EMR systems

Job description

CVS Health seeks a Behavioral Health Utilization Management Clinician to support members’ mental health outcomes. You will review services for medical necessity, coordinate with care teams, and provide crisis intervention as needed.

The role is remote with Louisiana preferred and CST hours (Sun-Thurs, 8:00 AM–5:00 PM CST). A Master’s degree is required for independently licensed clinicians, with 3+ years of clinical experience and EMR proficiency.