Remote Behavioral Health Utilization Clinician

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

Benefits offered by this job

Fully remote position

Shift differential 12.5%

Comprehensive benefits

Job summary

CVS Health is seeking a Behavioral Health Utilization Management Clinician for a fully remote role that spans nationwide. You will review preauthorization requests, apply evidence-based guidelines, and coordinate decisions with providers to ensure timely access to behavioral health services.

Ideal candidates hold an unrestricted behavioral health license (LPC/LMHC/LCMHC or RN), with 3+ years post-licensure experience in mental health and substance use disorders, plus utilization management or

Qualifications

• Active, unrestricted behavioral health clinical license in your state of residence (LPC, LMHC, LCMHC, RN)
• 3+ years of post-licensure behavioral health experience
• 3+ years of experience working with mental health and substance use disorders
• Utilization Management or Prior Authorization experience
• Managed Care experience
• Master's degree in Social Work, Counseling, or Psychology / RN licensure required

Responsibilities

• Review preauthorization requests for behavioral health services using evidence-based guidelines and clinical judgment
• Coordinate, document, and communicate utilization management decisions with providers and stakeholders
• Ability to manage crisis calls, assess risk, determine support needs, and coordinate interventions including suicide risk or welfare checks
• Apply clinical expertise to support quality, cost-effective care and positive member outcomes
• Work in a fast-paced, queue-based environment while managing multiple priorities
• Collaborate with providers and care teams to facilitate appropriate levels of care

Skills

Behavioral health license (LPC/LMHC/LC

Education

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

RN licensure

Job description

CVS Health is seeking a Behavioral Health Utilization Management Clinician for a fully remote role that spans nationwide. You will review preauthorization requests, apply evidence-based guidelines, and coordinate decisions with providers to ensure timely access to behavioral health services.

Ideal candidates hold an unrestricted behavioral health license (LPC/LMHC/LCMHC or RN), with 3+ years post-licensure experience in mental health and substance use disorders, plus utilization management or