Remote Behavioral Health Utilization Clinician

CVS Health; Yuma (AZ); Remote; USD 54,000 - 143,000; Full time

Benefits offered by this job

Shift differential 12.5%

Fully remote

Comprehensive benefits

Job summary

CVS Health is seeking a Behavioral Health Utilization Management Clinician for a 100% remote, nationwide role. You will review preauthorization requests, document decisions, and coordinate with providers to ensure timely, appropriate behavioral health services.

This full-time position offers a 12.5% shift differential for weekend hours and holidays, a comprehensive benefits package, and bonus program eligibility.

Qualifications

• Active, unrestricted behavioral health clinical license in your state of residence.
• 3+ years of post-licensure behavioral health experience.
• 3+ years of experience working with mental health and substance use disorders.
• Ability to effectively manage telephonic and computer-based work simultaneously.
• Utilization Management or Prior Authorization experience.

Responsibilities

• 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 and assess risk, including escalation for suicide risk and welfare checks.
• 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.

Skills

Behavioral health license

Telephonic work

Crisis management

Care coordination

Education

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

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

Job description

CVS Health is seeking a Behavioral Health Utilization Management Clinician for a 100% remote, nationwide role. You will review preauthorization requests, document decisions, and coordinate with providers to ensure timely, appropriate behavioral health services.

This full-time position offers a 12.5% shift differential for weekend hours and holidays, a comprehensive benefits package, and bonus program eligibility.