Remote Behavioral Health Utilization Clinician

CVS Health; Williamstown (NJ); Remote; USD 54,000 - 117,000; Full time

Benefits offered by this job

Fully remote opportunity

Consistent weekday schedule

Comprehensive benefits package

Medical, dental, and vision coverage

Paid time off

Job summary

CVS Health is seeking a licensed Behavioral Health clinician or Psychiatric RN to review authorization requests, ensuring appropriate levels of care and timely, evidence-based treatment. This remote, full-time role supports inpatient and ongoing behavioral health care across settings.

The position emphasizes medical necessity review, documentation, and collaboration with facilities and providers. Competitive benefits and bonus eligibility are included.

Qualifications

• Master's degree in Behavioral Health or related field required.
• Active, unrestricted Behavioral Health license (Master's level) or RN with psychiatric experience.
• Experience in utilization management and in inpatient behavioral health settings.

Responsibilities

• Review behavioral health assessments, treatment plans, and notes to evaluate medical necessity.
• Apply evidence-based guidelines to authorization decisions.
• Document determinations and rationale clearly and completely.
• Coordinate with facilities/providers for additional information as needed.
• Support discharge planning and transitions of care.
• Identify opportunities to improve quality and reduce denials.

Skills

Behavioral health utilization review

Clinical decision-making

Documentation

Education

Master's Degree in Behavioral Health

ADN with Behavioral Health experience

BSN

Tools

EMR/EHR systems

Job description

CVS Health is seeking a licensed Behavioral Health clinician or Psychiatric RN to review authorization requests, ensuring appropriate levels of care and timely, evidence-based treatment. This remote, full-time role supports inpatient and ongoing behavioral health care across settings.

The position emphasizes medical necessity review, documentation, and collaboration with facilities and providers. Competitive benefits and bonus eligibility are included.