Remote Behavioral Health Utilization Clinician

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

Job summary

CVS Health is seeking a Behavioral Health Utilization Management Clinician for a 100% remote nationwide role. You will review preauthorization requests, coordinate decisions with providers, and manage crisis calls with clinical judgment to ensure timely, appropriate behavioral health services.

Expect a fast-paced, team-based environment with collaboration across care teams. Active behavioral health license (LPC/LMHC/LCMHC or RN), 3+ years post-licensure, and Utilization Management or Prior

Qualifications

• Active, unrestricted independent behavioral health clinical license in your state
• LPC, LMHC, LCMHC or RN license options listed
• 3+ years of post-licensure behavioral health experience
• 3+ years of experience with mental health and substance use disorders
• Ability to manage telephonic and computer-based work simultaneously
• Hospital-based behavioral health experience
• Utilization Management or Prior Authorization experience
• Managed Care experience
• Masters in Social Work/Counseling/Psychology
• Bachelor in Nursing with Behavioral Health/Psychology emphasis

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
• 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

Crisis risk assessment

Telephonic & computer-based work

Care coordination

Education

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

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

Tools

Utilization Management

Prior Authorization

Managed Care

Job description

CVS Health is seeking a Behavioral Health Utilization Management Clinician for a 100% remote nationwide role. You will review preauthorization requests, coordinate decisions with providers, and manage crisis calls with clinical judgment to ensure timely, appropriate behavioral health services.

Expect a fast-paced, team-based environment with collaboration across care teams. Active behavioral health license (LPC/LMHC/LCMHC or RN), 3+ years post-licensure, and Utilization Management or Prior