Remote Behavioral Health Utilization Clinician

CVS Health; New Jersey; Remote; USD 54,000 - 117,000; Full time

Benefits offered by this job

Remote work flexibility

Bonus eligibility

Comprehensive benefits package

Job summary

CVS Health is seeking a Behavioral Health Utilization Management Clinician to join our remote team. This role supports members’ behavioral health needs by reviewing services for medical necessity, applying evidence-based guidelines, and coordinating with care teams to ensure quality outcomes.

The position requires an active behavioral health license (Louisiana or equivalent) or an unrestricted psychiatric RN license, with 3+ years of clinical experience and 1+ year EMR documentation experience.

Qualifications

• Active, unrestricted Behavioral Health license (Louisiana or equivalent)
• Active, unrestricted Compact RN license with psychiatric experience
• 3+ years behavioral health clinical practice
• 1+ year EMR documentation experience

Responsibilities

• Review behavioral health services and determine medical necessity
• Apply evidence-based guidelines across levels of care
• Coordinate utilization management decisions with care teams
• Provide triage and crisis intervention as needed
• Facilitate discharge planning and transitions of care
• Identify at-risk members and coordinate referrals
• Promote quality and cost-effective utilization
• Collaborate with stakeholders to support care management

Skills

Behavioral Health license

Compact RN license (psychiatric)

EMR documentation

Sunday–Thursday availability

Education

Master's degree in Behavioral Health

Bachelor's degree in Nursing

Tools

EMR systems

Job description

CVS Health is seeking a Behavioral Health Utilization Management Clinician to join our remote team. This role supports members’ behavioral health needs by reviewing services for medical necessity, applying evidence-based guidelines, and coordinating with care teams to ensure quality outcomes.

The position requires an active behavioral health license (Louisiana or equivalent) or an unrestricted psychiatric RN license, with 3+ years of clinical experience and 1+ year EMR documentation experience.