Remote Behavioral Health Utilization Clinician

CVS Health; Salem (NH); Remote; USD 36,000 - 77,000; Full time

Benefits offered by this job

Comprehensive benefits package

Paid time off

Retirement savings options

Wellness programs

Remote work flexibility

Job summary

CVS Health is seeking a Behavioral Health Utilization Management Clinician for a remote role with a Louisiana preference. You will oversee utilization decisions, coordinate care with providers, and support crisis intervention and discharge planning to improve member outcomes.

Qualified clinicians must hold an active Behavioral Health license in Louisiana or an unrestricted Compact RN license with psychiatric experience, plus 3+ years in the field and EMR experience.

Qualifications

• Active, unrestricted Behavioral Health license in Louisiana (LCSW, LCPC, LMFT, LPCC, LPAT, LPC) or
• Active, unrestricted Compact RN license with psychiatric specialty experience.
• 3+ years of behavioral health clinical practice experience in settings like psychiatric hospital or behavioral health treatment.
• 1+ year of EMR documentation experience.
• Must be able to work Sunday-Thursday, 8:00 AM - 5:00 PM CST, with some weekends/holidays.
• Experience in Managed Care, Utilization Review or Utilization Management.
• Behavioral health inpatient experience and system navigation skills.
• Master's degree required for independently licensed Behavioral Health clinicians.

Responsibilities

• Review behavioral health services to determine medical necessity and appropriateness.
• Coordinate utilization management decisions with providers and care teams.
• Provide triage support and crisis intervention as needed.
• Facilitate discharge planning and transitions of care.
• Identify at-risk members and coordinate referrals to programs and services.
• Promote quality, cost-effective healthcare utilization and outcomes.
• Collaborate with internal and external stakeholders to support care management.

Skills

Behavioral Health license

Compact RN license

EMR documentation experience

Sunday-Thursday availability

Utilization Management experience

RN with psychiatric specialty

CST time zone availability

Education

Master's degree in Behavioral Health

Licensed professional licensure

Job description

CVS Health is seeking a Behavioral Health Utilization Management Clinician for a remote role with a Louisiana preference. You will oversee utilization decisions, coordinate care with providers, and support crisis intervention and discharge planning to improve member outcomes.

Qualified clinicians must hold an active Behavioral Health license in Louisiana or an unrestricted Compact RN license with psychiatric experience, plus 3+ years in the field and EMR experience.