Remote Behavioral Health Utilization Clinician

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

Benefits offered by this job

Shift differential 12.5%

Fully remote

Job summary

CVS Health is seeking a Behavioral Health Utilization Management Clinician to support remote, nationwide care coordination and utilization decisions. You will review preauthorizations, collaborate with providers, and manage crisis cases while applying evidence-based guidelines and clinical judgment.

The role requires an independent BH license, 3+ years of BH or MH/SUD experience, and strong telework capabilities.

Qualifications

• Active, unrestricted independent BH clinical license in your state
• Master's degree in Social Work, Counseling, or Psychology
• 3+ years of post-licensure BH experience
• 3+ years of experience with mental health and substance use disorders
• Ability to manage telephonic and computer-based work simultaneously
• Hospital-based BH experience and Utilization Management or Prior Authorization experience
• Managed Care experience

Responsibilities

• Review preauthorization requests for BH services using guidelines and clinical judgment
• Coordinate, document, and communicate utilization management decisions with providers and stakeholders
• Manage crisis calls, assess risk, determine support needs, and escalate for suicide risk when necessary
• Apply clinical expertise to support quality, cost-effective care and positive member outcomes
• Work in a fast-paced queue-based environment and manage multiple priorities
• Collaborate with providers and care teams to facilitate appropriate levels of care

Skills

Licensed behavioral health clinician

LPC/LMHC/LCMHC

RN

3+ years post-licensure BH experience

3+ years MH/SUD experience

Telephonic/c computer-based work

Hospital-based BH experience

Utilization Management / Prior Auth

Managed Care experience

Master's in Social Work / Counseling /

Nursing with BH/Psych emphasis

Fully remote position in U.S.

Education

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

Bachelor's degree in Nursing with BH/Psych emphasis

Job description

CVS Health is seeking a Behavioral Health Utilization Management Clinician to support remote, nationwide care coordination and utilization decisions. You will review preauthorizations, collaborate with providers, and manage crisis cases while applying evidence-based guidelines and clinical judgment.

The role requires an independent BH license, 3+ years of BH or MH/SUD experience, and strong telework capabilities.