Remote Behavioral Health Utilization Clinician

CVS Health; Milton (MA); Remote; USD 36,000 - 77,000; Full time

Benefits offered by this job

Medical, dental, vision

Paid time off

Retirement savings options

Job summary

CVS Health seeks a Behavioral Health Utilization Management Clinician for remote support in the US, with Louisiana licensure preferred. The role requires a Master’s degree for independent clinicians or an RN with psychiatric specialty and active license.

You will review plans, coordinate UM decisions, and assist in care transitions. Expect 3+ years of behavioral health experience, EMR proficiency, and CST-based Sunday-Thursday work with occasional weekends.

Qualifications

• Active, unrestricted Behavioral Health license in Louisiana or an equivalent RN license with psychiatric specialty.
• 3+ years of behavioral health clinical practice experience.
• Experience with EMR documentation in clinical settings.
• Strong ability to work Sunday-Thursday with CST schedule.

Responsibilities

• Review behavioral health services and treatment plans to determine medical necessity and appropriateness 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 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

RN with psychiatric experience

EMR documentation

Care management

Education

Master’s degree

Bachelor’s in Nursing

Tools

EMR systems

Job description

CVS Health seeks a Behavioral Health Utilization Management Clinician for remote support in the US, with Louisiana licensure preferred. The role requires a Master’s degree for independent clinicians or an RN with psychiatric specialty and active license.

You will review plans, coordinate UM decisions, and assist in care transitions. Expect 3+ years of behavioral health experience, EMR proficiency, and CST-based Sunday-Thursday work with occasional weekends.