Remote Behavioral Health Utilization Clinician

CVS Health; Salem (NH); Teletrabalho; USD 54 000 - 143 000; Tempo integral

Vantagens oferecidas por esta oferta de emprego

Shift differential 12.5%

Resumo da oferta

CVS Health is hiring a Behavioral Health Utilization Management Clinician for a fully remote, nationwide role. The position emphasizes clinical expertise, utilization review, and care coordination to ensure timely, appropriate behavioral health services.

Responsibilities include reviewing preauthorization requests, documenting decisions, and coordinating care with providers. Requires an unrestricted behavioral health license and 3+ years of post-licensure experience, with a 12.5% shift

Qualificações

• Active, unrestricted independent behavioral health clinical license in your state of residence, including one of the following: LPC, LMHC, LCMHC
• RN license accepted
• 3+ years of post-licensure behavioral health experience
• 3+ years of experience working with mental health and substance use disorders
• Ability to effectively manage telephonic and computer-based work simultaneously
• Hospital-based behavioral health experience
• Utilization Management or Prior Authorization experience
• Managed Care experience
• Behavioral Health Clinicians: Master’s degree in Social Work, Counseling, or Psychology
• Registered Nurses: Bachelor’s degree in Nursing with an emphasis in Behavioral Health or Psychology
• Fully remote position available anywhere in the U. Additional 12.5% shift differential

Responsabilidades

• 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, self-harm concerns, and welfare checks when necessary.
• 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

Formação académica

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

Descrição da oferta de emprego

CVS Health is hiring a Behavioral Health Utilization Management Clinician for a fully remote, nationwide role. The position emphasizes clinical expertise, utilization review, and care coordination to ensure timely, appropriate behavioral health services.

Responsibilities include reviewing preauthorization requests, documenting decisions, and coordinating care with providers. Requires an unrestricted behavioral health license and 3+ years of post-licensure experience, with a 12.5% shift