Remote Behavioral Health Utilization Clinician

CVS Health; Texas; Remote; USD 36,000 - 77,000; Full time

Benefits offered by this job

Remote flexibility

Competitive benefits

Wellness programs

Job summary

CVS Health is seeking a Behavioral Health Utilization Management Clinician for a remote role with a Louisiana-preferred schedule. The position supports medical necessity reviews, discharge planning, and coordination across care teams to ensure quality outcomes.

Ideal candidates hold a Louisiana behavioral health license or a psychiatric RN, with 3+ years of clinical practice and EMR experience; Sunday–Thursday 8:00 AM–5:00 PM CST availability is required, with some weekends possible.

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 experience.
• 1+ year of Electronic Medical Record (EMR) documentation experience.
• Ability to work Sunday–Thursday, 8:00 AM–5:00 PM CST, with flexibility for weekends/holidays.

Responsibilities

• Review behavioral health services and treatment plans to determine medical necessity and appropriateness of care.
• 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 effective discharge planning and transitions of care.
• Identify members at risk for poor outcomes 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

Compact RN license

3+ years experience

EMR experience

Sunday–Thursday CST

Education

Master's degree

Bachelor's in Nursing

Job description

CVS Health is seeking a Behavioral Health Utilization Management Clinician for a remote role with a Louisiana-preferred schedule. The position supports medical necessity reviews, discharge planning, and coordination across care teams to ensure quality outcomes.

Ideal candidates hold a Louisiana behavioral health license or a psychiatric RN, with 3+ years of clinical practice and EMR experience; Sunday–Thursday 8:00 AM–5:00 PM CST availability is required, with some weekends possible.