Remote Behavioral Health Utilization Clinician

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

Benefits offered by this job

Shift differential

Remote work

Full-time benefits

Job summary

CVS Health is seeking a Behavioral Health Utilization Management Clinician for a 100% remote role nationwide. The position emphasizes clinical judgment, care coordination, and timely utilization decisions, with a 12.5% shift differential for weekend hours.

Requirements include active behavioral health licensure, 3+ years of post-licensure experience in mental health/substance use, and proficiency with telephonic and computer-based work. Full-time role with comprehensive benefits.

Qualifications

• Active, unrestricted independent behavioral health clinical license in your state of residence with one of: LPC, LMHC, LCMHC, RN
• 3+ years post-licensure behavioral health experience
• 3+ years 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
• Fully remote position anywhere in the U.S. with shift differential
• Master's degree for Behavioral Health Clinicians or Nursing degree for RN pathway

Responsibilities

• Review preauthorization requests for behavioral health services using guidelines
• Coordinate, document, and communicate UM decisions with providers and stakeholders
• Manage crisis calls and assess risk, coordinating appropriate interventions
• Support quality and cost-effective care and positive member outcomes
• Work in a fast-paced queue-based environment with multiple priorities
• Collaborate with providers and care teams to facilitate appropriate levels of care

Skills

Telephonic and computer-based work

Crisis risk assessment

Clinical judgment

Education

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

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

Job description

CVS Health is seeking a Behavioral Health Utilization Management Clinician for a 100% remote role nationwide. The position emphasizes clinical judgment, care coordination, and timely utilization decisions, with a 12.5% shift differential for weekend hours.

Requirements include active behavioral health licensure, 3+ years of post-licensure experience in mental health/substance use, and proficiency with telephonic and computer-based work. Full-time role with comprehensive benefits.