Remote Behavioral Health Utilization Clinician

CVS Health; Maine; Remote; USD 36,000 - 77,000; Full time

Job summary

CVS Health is hiring a Behavioral Health Utilization Management Clinician for a remote role with a Louisiana preferred lens and a Sunday-Thursday schedule. The role focuses on evaluating services, coordinating care, and supporting evidence-based treatment planning for members.

The position requires licensed behavioral health professionals or psychiatric RN with experience, plus 3+ years in the field and EMR documentation skills. Competitive benefits and a base hourly pay are offered.

Qualifications

• Active, unrestricted Behavioral Health license in Louisiana or equivalent.
• Active, unrestricted Compact RN license with psychiatric specialty experience.
• 3+ years of behavioral health clinical practice, such as psychiatric hospital, residential treatment, or behavioral health treatment settings.
• 1+ year of Electronic Medical Record (EMR) documentation experience.
• Ability to work Sunday–Thursday, 8:00 AM–5:00 PM CST, with flexibility for weekends/holidays.

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 multiple 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 members at risk for poor outcomes and coordinate referrals to 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 clinical practice

EMR documentation

Crisis intervention

Care coordination

Scheduling flexibility

Education

Master's degree

RN with psychiatric experience

Tools

EMR systems

Job description

CVS Health is hiring a Behavioral Health Utilization Management Clinician for a remote role with a Louisiana preferred lens and a Sunday-Thursday schedule. The role focuses on evaluating services, coordinating care, and supporting evidence-based treatment planning for members.

The position requires licensed behavioral health professionals or psychiatric RN with experience, plus 3+ years in the field and EMR documentation skills. Competitive benefits and a base hourly pay are offered.