Remote Behavioral Health Utilization Clinician

CVS Health; Maryland; Remote; USD 54,000 - 143,000; Full time

Benefits offered by this job

Comprehensive benefits

Fully remote work

Shift differential 12.5%

Job summary

CVS Health is seeking a Behavioral Health Utilization Management Clinician for a fully remote role across the United States. The position focuses on clinical review, care coordination, and escalation of risk, with a 40-hour workweek and a 12.5% shift differential.

You will support timely behavioral health services, collaborate with care teams, and help ensure appropriate levels of care while maintaining high quality and safety.

Qualifications

• Active, unrestricted independent behavioral health license in your state (LCSW/LICSW/LISW/LMSW, LPC/LMHC/LCMHC, LMFT, Clinical Psychologist, RN)
• 3+ years post-licensure behavioral health experience
• 3+ years of experience with mental health and substance use disorders
• Ability to manage telephonic and computer-based work simultaneously
• High-speed internet (min 25 Mbps down / 3 Mbps up)

Responsibilities

• Review preauthorization requests for behavioral health services using evidence-based guidelines and clinical judgment
• Coordinate, document, and communicate utilization management decisions with providers and stakeholders
• Ability to manage crisis calls, apply clinical judgment to assess risk, determine support needs, and coordinate interventions
• Apply clinical expertise to support quality, cost-effective care and positive member outcomes
• Work in a fast-paced, queue-based environment while managing multiple priorities
• Collaborate with providers and care teams to facilitate appropriate levels of care

Skills

Independent clinical license (BH)

Telephonic work

Crisis management

Clinical documentation

Time management

Communication with providers

Education

Master's degree in Social Work/Counseling/Psychology

Bachelor's degree in Nursing (Behavioral Health/Psychology)

Job description

CVS Health is seeking a Behavioral Health Utilization Management Clinician for a fully remote role across the United States. The position focuses on clinical review, care coordination, and escalation of risk, with a 40-hour workweek and a 12.5% shift differential.

You will support timely behavioral health services, collaborate with care teams, and help ensure appropriate levels of care while maintaining high quality and safety.