Remote Behavioral Health Utilization Clinician - Care Coordinator

CVS Health; Bristol (RI); Remote; USD 54,000 - 143,000; Full time

Benefits offered by this job

Shift differential 12.5%

Remote role

Job summary

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

A licensed BH professional with 3+ years of post-licensure BH experience is required. Responsibilities include collaboration with care teams, documenting decisions, and supporting quality and cost-effective member

Qualifications

• Active, unrestricted BH license in your state of residence (BH clinical license)
• 3+ years post-licensure BH experience
• 3+ years of experience with mental health and substance use disorders
• Ability to manage telephonic and computer-based work simultaneously
• Hospital-based BH experience
• Utilization management or prior authorization experience
• Managed care experience
• Master's degree in Social Work, Counseling, or Psychology (for BH clinicians)
• Bachelor's degree in Nursing with BH emphasis (for RN)

Responsibilities

• Review preauthorization requests for behavioral health services using guidelines and clinical judgment
• Coordinate, document, and communicate utilization management decisions with providers and stakeholders
• Ability to manage crisis calls and assess risk with appropriate interventions
• Apply clinical expertise to support quality, cost-effective care and positive member outcomes
• Work in a fast-paced, queue-based environment and manage multiple priorities
• Collaborate with providers and care teams to facilitate appropriate levels of care

Skills

Behavioral health license

Post-licensure BH experience

Mental health & substance use

Telephonic & computer-based work

Hospital-based BH experience

Utilization management experience

Managed care experience

Remote work eligibility

Education

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

Bachelor's degree in Nursing with BH emphasis

Job description

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

A licensed BH professional with 3+ years of post-licensure BH experience is required. Responsibilities include collaboration with care teams, documenting decisions, and supporting quality and cost-effective member