Remote Behavioral Health Utilization Clinician

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

Benefits offered by this job

Shift differential 12.5%

Remote work (100% remote)

Weekend coverage

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 situations with clinical judgment.

The position requires an independent behavioral health license, a relevant master’s degree for clinicians, and 3+ years of post-licensure experience in mental health and substance use disorders. A 12.5% shift differential applies for weekend coverage.

Qualifications

• Active, unrestricted independent behavioral health clinical license in your state of residence.
• Master’s degree in Social Work, Counseling, or Psychology for Behavioral Health clinicians.
• RN with Bachelor's degree in Nursing and emphasis in Behavioral Health or Psychology as an alternative.
• 3+ years of post-licensure behavioral health experience.
• 3+ years of experience with mental health and substance use disorders.

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.
• Manage crisis calls and apply clinical judgment to assess risk and determine needed interventions.
• Support quality, cost-effective care and positive member outcomes.
• Work in a fast-paced, queue-based environment while prioritizing multiple tasks.
• Collaborate with providers and care teams to facilitate appropriate levels of care.

Skills

Clinical judgment

Telephonic work

Care coordination

Crisis management

Multitasking

Communication

Education

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

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

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 situations with clinical judgment.

The position requires an independent behavioral health license, a relevant master’s degree for clinicians, and 3+ years of post-licensure experience in mental health and substance use disorders. A 12.5% shift differential applies for weekend coverage.