Remote Behavioral Health Utilization Clinician (LA)

CVS Health; Iowa; Remote; USD 36,000 - 77,000; Full time

Job summary

CVS Health is seeking a Behavioral Health Utilization Management Clinician for a remote role with a Louisiana-preferred candidate. The position supports medical necessity determinations, evidence-based care guidelines, and care coordination across teams.

You will engage in crisis intervention, discharge planning, and referrals within a 40-hour CST schedule. The role requires licensed behavioral health professionals or psychiatric-registered nurses with 3+ years of clinical practice, EMR

Qualifications

• Active, unrestricted Behavioral Health license in Louisiana (LCSW, LCPC, LMFT, LPCC, LPAT, LPC) or
• Active, unrestricted Compact RN license with psychiatric specialty experience
• 3+ years of behavioral health clinical practice experience
• 1+ year of Electronic Medical Record (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 multiple levels of care
• Coordinate and communicate utilization management decisions with providers and care teams
• Provide triage support and crisis intervention as needed
• Facilitate effective discharge planning and transitions of care
• Identify members at risk for poor outcomes and coordinate referrals to additional programs and services
• Promote quality, cost-effective healthcare utilization and positive member outcomes
• Collaborate with internal and external stakeholders to support comprehensive care management

Skills

Behavioral health license

RN license (psychiatric)

EMR experience

Flexibility with schedule

Education

Master's in Behavioral Health

Nursing degree

Tools

EMR software

Job description

CVS Health is seeking a Behavioral Health Utilization Management Clinician for a remote role with a Louisiana-preferred candidate. The position supports medical necessity determinations, evidence-based care guidelines, and care coordination across teams.

You will engage in crisis intervention, discharge planning, and referrals within a 40-hour CST schedule. The role requires licensed behavioral health professionals or psychiatric-registered nurses with 3+ years of clinical practice, EMR