Remote Behavioral Health Utilization Clinician

CVS Health; Louisiana (MO); Hybrid; USD 36,000 - 77,000; Full time

Job summary

CVS Health is seeking a Behavioral Health Utilization Management Clinician to support members from a remote location with a Louisiana preference. The role requires a licensed BH professional or psychiatric RN, with years of clinical practice and EMR experience, working a Tue-Sat or Mon-Fri CST schedule.

The team focuses on evidence-based care, care coordination, and quality outcomes. Responsibilities include reviewing service plans, applying guidelines, coordinating decisions, and facilitating

Qualifications

• Active, unrestricted behavioral health license in Louisiana (LCSW/LCPC/LMFT/LPCC/LPAT/LPC) or compact RN with psychiatric focus.
• 3+ years of behavioral health clinical practice experience.
• 1+ year of EMR documentation experience.
• Ability to work Monday-Friday, 8:00 AM–5:00 PM CST or Tuesday-Saturday, 8:00 AM–5:00 PM CST with occasional weekends/holidays.

Responsibilities

• Review behavioral health services to determine medical necessity and appropriateness of care.
• Apply evidence-based guidelines and clinical best practices across levels 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 members at risk 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

Behavioral Health license (LA)

Compact RN license (psychiatric)

Clinical practice 3+ years

EMR documentation experience

Flexible work schedule (Mon-Fri or Tue

Education

Master's degree in Behavioral Health

BSN or nursing degree

Tools

Electronic Medical Records (EMR)

Job description

CVS Health is seeking a Behavioral Health Utilization Management Clinician to support members from a remote location with a Louisiana preference. The role requires a licensed BH professional or psychiatric RN, with years of clinical practice and EMR experience, working a Tue-Sat or Mon-Fri CST schedule.

The team focuses on evidence-based care, care coordination, and quality outcomes. Responsibilities include reviewing service plans, applying guidelines, coordinating decisions, and facilitating