Remote Behavioral Health Utilization Clinician

CVS Health; United States; Remote; USD 61,000 - 130,000; Full time

Benefits offered by this job

Medical, dental, vision coverage

Paid time off

Retirement savings options

Job summary

CVS Health is seeking a full-time remote Utilization Management Clinician. You will apply clinical expertise to review treatment plans, coordinate care, and determine coverage decisions for Medicare DSNP/Medicare Advantage populations. Strong RN licensure with behavioral health focus and inpatient experience are required.

The role involves collaboration with providers and internal teams, flexible scheduling, and a base salary within CVS Health's pay range. 40 hours weekly, with potential bonuses.

Qualifications

• Active, current, and unrestricted RN licensure with psychiatric specialty, certification, or relevant experience.
• 1+ years of behavioral health utilization review/UM experience required.
• 3+ years in an inpatient hospital setting with behavioral health members.

Responsibilities

• Review and evaluate treatment plans across levels of care.
• Coordinate, monitor, and assess service options for cost-effective care.
• Collect and assess information to determine coverage recommendations and discharge planning.

Skills

RN licensure

Behavioral health UM experience

Independent work

Multitasking

Education

Master’s-level behavioral health degree

RN with behavioral health experience

Associate degree

Job description

CVS Health is seeking a full-time remote Utilization Management Clinician. You will apply clinical expertise to review treatment plans, coordinate care, and determine coverage decisions for Medicare DSNP/Medicare Advantage populations. Strong RN licensure with behavioral health focus and inpatient experience are required.

The role involves collaboration with providers and internal teams, flexible scheduling, and a base salary within CVS Health's pay range. 40 hours weekly, with potential bonuses.