Remote Behavioral Health Utilization Clinician

CVS Health; Ohio; Teletrabalho; USD 36 000 - 77 000; Tempo integral

Resumo da oferta

CVS Health seeks a remote Behavioral Health Utilization Management Clinician with an active Louisiana behavioral health license or psychiatric RN background. The role requires 3+ years of clinical practice, EMR documentation, and Sunday-Thursday CST availability.

Responsibilities include reviewing services for medical necessity, applying guidelines, coordinating decisions with care teams, and ensuring quality care while maintaining cost-effectiveness. Remote with Louisiana preference.

Qualificações

• Active, unrestricted Behavioral Health license in Louisiana or RN with psychiatric specialty experience
• 3+ years of behavioral health clinical practice experience
• 1+ year of EMR documentation experience
• Ability to work Sunday - Thursday, 8:00 AM - 5:00 PM CST, with flexibility for weekends/holidays

Responsabilidades

• Review behavioral health services and treatment plans to determine medical necessity and appropriateness of care
• Apply evidence-based guidelines across multiple levels 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
• Promote quality, cost-effective healthcare utilization
• Collaborate with internal and external stakeholders to support care management

Conhecimentos

Behavioral health license

EMR experience

Clinical practice 3+ years

CST schedule flexibility

Formação académica

Master's degree in Behavioral Health

RN with psychiatric specialty (optional)

Ferramentas

EMR systems

Descrição da oferta de emprego

CVS Health seeks a remote Behavioral Health Utilization Management Clinician with an active Louisiana behavioral health license or psychiatric RN background. The role requires 3+ years of clinical practice, EMR documentation, and Sunday-Thursday CST availability.

Responsibilities include reviewing services for medical necessity, applying guidelines, coordinating decisions with care teams, and ensuring quality care while maintaining cost-effectiveness. Remote with Louisiana preference.