Remote Behavioral Health Utilization Clinician

CVS Health; Town of King (WI); Remote; USD 36,000 - 77,000; Full time

Job summary

CVS Health is seeking a Behavioral Health Utilization Management Clinician to support members' mental health care remotely, with Louisiana preferred. The role focuses on medical necessity reviews, care coordination, and evidence-based treatment planning.

Candidates need active behavioral health licensure in Louisiana or an active psychiatric RN license, 3+ years of clinical experience, and ability to work Sunday-Thursday CST; remote flexibility and team support.

Qualifications

• Active, unrestricted Behavioral Health license in Louisiana.
• 3+ years of behavioral health clinical practice experience.
• Master's degree required for independently licensed clinicians.
• RN with psychiatric specialty experience considered.
• Experience with managed care or utilization management.

Responsibilities

• Review behavioral health services and determine medical necessity and appropriateness 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

Crisis intervention

Care coordination

EMR documentation experience

Education

Master's degree

Bachelor's in Nursing

Tools

EMR systems

Job description

CVS Health is seeking a Behavioral Health Utilization Management Clinician to support members' mental health care remotely, with Louisiana preferred. The role focuses on medical necessity reviews, care coordination, and evidence-based treatment planning.

Candidates need active behavioral health licensure in Louisiana or an active psychiatric RN license, 3+ years of clinical experience, and ability to work Sunday-Thursday CST; remote flexibility and team support.