Remote Behavioral Health Utilization Clinician

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

Benefits offered by this job

Remote work nationwide

Shift differential 12.5%

Comprehensive benefits

Bonus eligibility

Job summary

CVS Health is seeking a Behavioral Health Utilization Management Clinician to work 100% remotely from anywhere in the United States. The role focuses on reviewing preauthorization requests, coordinating utilization decisions with providers, and managing crisis calls with clinical judgment.

You must hold an active, unrestricted behavioral health license and have several years of post-licensure experience with mental health and substance use disorders.

Qualifications

• Active, unrestricted independent behavioral health clinical license in your state of residence.
• 3+ years of post-licensure behavioral health experience.
• 3+ years of experience with mental health and substance use disorders.

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 appropriate interventions, including escalation for suicide risk, self-harm concerns, and welfare checks when necessary.
• 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

Clinical license (BH)

Telehealth / phone-based work

Crisis management

Time management

Education

Master's degree in Social Work, Counseling, or Psychology

Bachelor's degree in Nursing with emphasis in Behavioral Health or Psychology

Tools

EHR systems

Video/Phone conferencing

Job description

CVS Health is seeking a Behavioral Health Utilization Management Clinician to work 100% remotely from anywhere in the United States. The role focuses on reviewing preauthorization requests, coordinating utilization decisions with providers, and managing crisis calls with clinical judgment.

You must hold an active, unrestricted behavioral health license and have several years of post-licensure experience with mental health and substance use disorders.