Remote Behavioral Health Utilization Clinician

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

Benefits offered by this job

12.5% shift differential

Fully remote position in the U.S.

Bonus eligibility

Job summary

CVS Health is seeking a Behavioral Health Utilization Management Clinician for a fully remote role available nationwide. You will review preauthorization requests, coordinate decisions with providers, and manage crisis calls when needed, applying clinical judgment to ensure timely, appropriate care.

Role requires 3+ years post-licensure in behavioral health, an active license, and the ability to work telephonically and via computer-based systems.

Qualifications

• Active, unrestricted behavioral health license in your state.
• 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.

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, assess risk, and coordinate interventions including suicide risk escalation.
• 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

Behavioral health license

3+ years post-licensure

Mental health & SUD experience

Telephonic & computer-based work

Education

Master's in Social Work / Counseling / Psychology

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

Tools

Telehealth platforms

Job description

CVS Health is seeking a Behavioral Health Utilization Management Clinician for a fully remote role available nationwide. You will review preauthorization requests, coordinate decisions with providers, and manage crisis calls when needed, applying clinical judgment to ensure timely, appropriate care.

Role requires 3+ years post-licensure in behavioral health, an active license, and the ability to work telephonically and via computer-based systems.