Remote Behavioral Health Utilization Clinician

CVS Health; Wilmington (VT); Remote; USD 54.000 - 143.000; Vollzeit

Benefits dieser Stelle

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, coordinate decisions with providers, and manage crisis calls with clinical judgment while ensuring appropriate levels of care.

Qualified candidates have an active unrestricted behavioral health license, post-licensure BH experience, and a Master’s in Social Work/Counseling/Psychology (or RN with BH emphasis).

Qualifikationen

• Active, unrestricted behavioral health license in state of residence.
• LPC, LMHC, LCMHC credentialed prevalent.
• RN credentialed.
• 3+ years post-licensure behavioral health experience.
• 3+ years experience 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.
• Master's degree in Social Work, Counseling, or Psychology.
• Bachelor's degree in Nursing with emphasis in Behavioral Health or Psychology.
• Fully remote position available anywhere in the U.S. with 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.
• Manage crisis calls using clinical judgment and assess risk, coordinating appropriate interventions.
• Apply clinical expertise to support quality and cost-effective care and positive member outcomes.
• Work in a fast-paced, queue-based environment, managing multiple priorities.
• Collaborate with providers and care teams to facilitate appropriate levels of care.

Kenntnisse

Behavioral health license

LPC/LMHC/LCMHC

RN (Nursing)

3+ years post-licensure

Mental health & substance use

Telephonic & computer-based work

Hospital-based BH experience

Utilization Management/Prior Author

Managed Care experience

Master's in Social Work/Counseling/Psy

Bachelor's in Nursing w/ BH emphasis

Ausbildung

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

Bachelor's degree in Nursing with Behavioral Health emphasis

Jobbeschreibung

CVS Health is seeking a Behavioral Health Utilization Management Clinician for a 100% remote nationwide role. You will review preauthorization requests, coordinate decisions with providers, and manage crisis calls with clinical judgment while ensuring appropriate levels of care.

Qualified candidates have an active unrestricted behavioral health license, post-licensure BH experience, and a Master’s in Social Work/Counseling/Psychology (or RN with BH emphasis).