Remote Behavioral Health Utilization Clinician

CVS Health; Oregon; Hybrid; USD 54,000 - 143,000; Full time

Benefits offered by this job

Fully remote

Shift differential

Bonus eligible

Job summary

CVS Health is seeking a Behavioral Health Utilization Management Clinician for a fully remote role nationwide. The position involves reviewing preauthorization requests, coordinating decisions, and managing crisis calls while ensuring timely, appropriate behavioral health services and positive member outcomes.

Candidates must hold an eligible behavioral health license and have 3+ years of post-licensure experience with mental health and substance use disorders.

Qualifications

• 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
• High-speed residential internet service (minimum 25 Mbps download / 3 Mbps upload)

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, including escalation for suicide risk
• 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

LCSW / LICSW / LISW / LMSW

LPC / LMHC / LCMHC

LMFT

Clinical Psychologist

RN

Education

Master's in Social Work / Counseling / Psychology

Bachelor's in Nursing (Behavioral Health)

Job description

CVS Health is seeking a Behavioral Health Utilization Management Clinician for a fully remote role nationwide. The position involves reviewing preauthorization requests, coordinating decisions, and managing crisis calls while ensuring timely, appropriate behavioral health services and positive member outcomes.

Candidates must hold an eligible behavioral health license and have 3+ years of post-licensure experience with mental health and substance use disorders.