Remote Behavioral Health Utilization Clinician

CVS Health; West Virginia; Remote; USD 54,000 - 117,000; Full time

Benefits offered by this job

Remote flexibility

Comprehensive benefits package

Bonus eligibility

Job summary

CVS Health is seeking a Remote Behavioral Health Utilization Management Clinician to support members across the U.S. with a Sunday–Thursday schedule in CST. This role emphasizes evidence-based care, utilization decisions, and care coordination to ensure appropriate behavioral health services.

Ideal candidates bring active licenses (Louisiana BH license or psychiatric RN) and 3+ years of clinical practice plus EMR experience. Remote flexibility is offered with a comprehensive benefits package.

Qualifications

• Active, unrestricted Behavioral Health license in Louisiana (LCSW, LCPC, LMFT, LPCC, LPAT, LPC) or
• Active, unrestricted Compact RN license with psychiatric specialty experience
• 3+ years of behavioral health clinical practice (e.g., psychiatric hospital, residential treatment, behavioral health settings)
• 1+ year of Electronic Medical Record (EMR) documentation experience
• Ability to work Sunday–Thursday, 8:00 AM–5:00 PM CST, with some weekends/holidays"

Responsibilities

• Review behavioral health services and treatment plans to determine medical necessity and appropriateness of care
• Apply evidence-based guidelines and clinical best practices across multiple levels of care
• Coordinate and communicate utilization management decisions with providers and care teams
• Provide triage support and crisis intervention as needed
• Facilitate effective discharge planning and transitions of care
• Identify members at risk for poor outcomes 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 (Louisiana)

RN license with psychiatric specialty

Education

Master's degree in Behavioral Health

BSN or RN with psych specialty

Tools

EMR systems

Job description

CVS Health is seeking a Remote Behavioral Health Utilization Management Clinician to support members across the U.S. with a Sunday–Thursday schedule in CST. This role emphasizes evidence-based care, utilization decisions, and care coordination to ensure appropriate behavioral health services.

Ideal candidates bring active licenses (Louisiana BH license or psychiatric RN) and 3+ years of clinical practice plus EMR experience. Remote flexibility is offered with a comprehensive benefits package.