Remote Behavioral Health Utilization Clinician

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

Benefits offered by this job

Remote work

Shift differential 12.5%

Comprehensive benefits

Job summary

CVS Health is seeking a Behavioral Health Utilization Management Clinician to work 100% remote nationwide. You will review preauthorizations, coordinate decisions with providers, and manage crisis calls while applying clinical judgment to support safe, appropriate care.

Ideal candidates hold an unrestricted behavioral health license, have 3+ years of post-licensure experience with mental health/substance use, and possess a Master’s in Social Work, Counseling, or Psychology (RN with related

Qualifications

• Active, unrestricted independent behavioral health clinical license in your state.
• 3+ years post-licensure behavioral health experience.
• 3+ years of experience with mental health and substance use disorders.
• Experience in Utilization Management or Prior Authorization.
• Managed Care experience helpful.

Responsibilities

• Review preauthorization requests for behavioral health services using guidelines and clinical judgment.
• Coordinate, document, and communicate utilization management decisions with providers.
• Manage crisis calls and assess risk, coordinating appropriate interventions.
• Apply clinical expertise to support quality and cost-effective care.
• Collaborate with care teams to facilitate appropriate levels of care.

Skills

Telephonic work

Computer-based work

Crisis management

Education

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

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

Tools

Utilization Management

Job description

CVS Health is seeking a Behavioral Health Utilization Management Clinician to work 100% remote nationwide. You will review preauthorizations, coordinate decisions with providers, and manage crisis calls while applying clinical judgment to support safe, appropriate care.

Ideal candidates hold an unrestricted behavioral health license, have 3+ years of post-licensure experience with mental health/substance use, and possess a Master’s in Social Work, Counseling, or Psychology (RN with related