Remote Behavioral Health Utilization Clinician (LA)

CVS Health; Guin (AL); Remote; USD 36,000 - 77,000; Full time

Benefits offered by this job

Remote flexibility

Benefits package

Bonus eligibility

Job summary

CVS Health is seeking a Behavioral Health Utilization Management Clinician to join our remote team. The role focuses on determining medical necessity, coordinating care, and applying best practices across levels of care to support effective treatment planning.

Candidates should hold an active behavioral health license (Louisiana options) or a compact RN with psychiatric experience, with 3+ years of related practice and at least 1 year of EMR documentation. Weekend flexibility may be required.

Qualifications

• 3+ years of behavioral health clinical practice experience (e.g., psychiatric hospital, residential treatment, or behavioral health settings).
• 1+ year of EMR documentation experience.
• Ability to work Sunday–Thursday, 8:00 AM–5:00 PM CST, with occasional 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 levels of care.
• Coordinate and communicate utilization management decisions with providers and care teams.
• Provide triage support and crisis intervention as needed.
• Facilitate discharge planning and transitions of care.
• Identify at-risk members and coordinate referrals to programs and services.
• Support cost-effective utilization and positive member outcomes.
• Collaborate with stakeholders to support comprehensive care management.

Skills

Behavioral health license

RN license with psych specialty

EMR documentation experience

Education

Master's degree in Behavioral Health

Bachelor's degree in Nursing

Job description

CVS Health is seeking a Behavioral Health Utilization Management Clinician to join our remote team. The role focuses on determining medical necessity, coordinating care, and applying best practices across levels of care to support effective treatment planning.

Candidates should hold an active behavioral health license (Louisiana options) or a compact RN with psychiatric experience, with 3+ years of related practice and at least 1 year of EMR documentation. Weekend flexibility may be required.