Remote Behavioral Health Utilization Clinician

CVS Health; South Dakota; Remote; USD 54,000 - 117,000; Full time

Benefits offered by this job

Bonus eligibility

Remote flexibility

Job summary

CVS Health is seeking a licensed Behavioral Health Utilization Management Clinician to support members remotely, with a Louisiana preference. The role focuses on ensuring evidence-based behavioral health services, coordinating care, and guiding treatment planning.

Responsibilities include reviewing treatment plans, applying guidelines, triage and crisis support, discharge planning, and collaboration with care teams. Weekend/holiday flexibility may be required.

Qualifications

• Active, unrestricted Behavioral Health license in Louisiana (LCSW, LCPC, LMFT, LPCC, LPAT, LPC) or Compact RN with psychiatric specialty
• 3+ years of behavioral health clinical practice in settings such as psychiatric hospital or residential treatment
• 1+ year of EMR documentation experience
• Sunday–Thursday, 8:00 AM–5:00 PM CST with occasional weekends/holidays

Responsibilities

• Review behavioral health services and treatment plans to determine medical necessity
• Apply evidence-based guidelines and clinical best practices across multiple levels of care
• Coordinate and communicate utilization management decisions with providers and care teams
• Provide triage support and crisis intervention as needed
• Facilitate discharge planning and transitions of care
• Identify members at risk and coordinate referrals to additional programs and services
• Promote quality, cost-effective healthcare utilization and positive member outcomes
• Collaborate with internal and external stakeholders to support comprehensive care management

Skills

Behavioral health license

Registered Nurse license

EMR experience

Clinical practice experience

EMR systems

Education

Master's degree for BH clinicians

Nursing degree (BSN)

Tools

EMR systems

Job description

CVS Health is seeking a licensed Behavioral Health Utilization Management Clinician to support members remotely, with a Louisiana preference. The role focuses on ensuring evidence-based behavioral health services, coordinating care, and guiding treatment planning.

Responsibilities include reviewing treatment plans, applying guidelines, triage and crisis support, discharge planning, and collaboration with care teams. Weekend/holiday flexibility may be required.