Remote Behavioral Health Utilization Clinician

4062 Aetna Resources, LLC; Louisiana (MO); Hybrid; USD 74,473,000 - 161,033,000; Full time

Job summary

CVS Health is seeking a Behavioral Health Utilization Management Clinician for a remote Louisiana-based role with a Sunday through Thursday schedule. You will review services for medical necessity, apply evidence-based guidelines, and coordinate utilization decisions with care teams across multiple levels of care.

The position requires an active Louisiana Behavioral Health license or psychiatric RN with 3+ years of clinical experience and EMR documentation experience, plus flexibility for

Qualifications

• Active, unrestricted Louisiana Behavioral Health license (LCSW, LCPC, LMFT, LPCC, LPAT, LPC) or active unrestricted Compact RN with psych experience.
• 3+ years of behavioral health clinical practice experience.
• 1+ year of EMR documentation experience.
• Ability to work Sunday-Thursday, 8:00 AM–5:00 PM CST, with occasional weekend/holiday flexibility.

Responsibilities

• Review behavioral health services to determine medical necessity and appropriateness of care.
• Apply evidence-based guidelines across multiple levels of care.
• Coordinate utilization 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.
• Promote quality, cost-effective healthcare utilization and positive outcomes.
• Collaborate with stakeholders to support comprehensive care management.

Skills

EMR documentation

Behavioral Health licensure

Psychiatric RN option

Education

Master's degree required for independently licensed Behavioral Health clinicians

Tools

EMR systems

Job description

CVS Health is seeking a Behavioral Health Utilization Management Clinician for a remote Louisiana-based role with a Sunday through Thursday schedule. You will review services for medical necessity, apply evidence-based guidelines, and coordinate utilization decisions with care teams across multiple levels of care.

The position requires an active Louisiana Behavioral Health license or psychiatric RN with 3+ years of clinical experience and EMR documentation experience, plus flexibility for