Remote Behavioral Health Utilization Clinician

CVS Health; West Virginia; Remote; USD 54.000 - 143.000; Vollzeit

Benefits dieser Stelle

Remote work

Shift differential 12.5%

Zusammenfassung

CVS Health is seeking a Behavioral Health Utilization Management Clinician for a 100% remote, nationwide role. You will review preauthorization requests, apply evidence-based guidelines, and coordinate care with providers while supporting timely, appropriate services.

The role requires an active behavioral health license (LPC/LMHC/LCMHC or RN) and 3+ years of post-licensure experience in mental health and substance use. It offers a 12.5% shift differential and full-time benefits.

Qualifikationen

• Active, unrestricted independent behavioral health clinical license in your state of residence.
• LPC, LMHC, or LCMHC (or RN) licensed professionals eligible.
• 3+ years of post-licensure behavioral health experience.
• 3+ years of experience working with mental health and substance use disorders.
• Ability to manage telephonic and computer-based work simultaneously.
• Hospital-based behavioral health experience.
• Utilization Management or Prior Authorization experience.
• Managed Care experience.
• Behavioral Health Clinicians: Master's degree in Social Work, Counseling, or Psychology.
• Registered Nurses: Bachelor's degree in Nursing with an emphasis in Behavioral Health or Psychology.
• Fully remote position available anywhere in the U.S. Additional 12.5% shift differential.

Aufgaben

• 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, and coordinate appropriate interventions, including escalation for suicide risk, self-harm concerns, and welfare checks when necessary.
• 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.

Kenntnisse

Crisis management

Telephonic communication

Clinical decision making

Ausbildung

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

Bachelor's degree in Nursing with emphasis in Behavioral Health or Psychology

Jobbeschreibung

CVS Health is seeking a Behavioral Health Utilization Management Clinician for a 100% remote, nationwide role. You will review preauthorization requests, apply evidence-based guidelines, and coordinate care with providers while supporting timely, appropriate services.

The role requires an active behavioral health license (LPC/LMHC/LCMHC or RN) and 3+ years of post-licensure experience in mental health and substance use. It offers a 12.5% shift differential and full-time benefits.