Remote Behavioral Health Utilization Clinician – Weekend Shifts

CVS Health; Lake Michigan Beach (MI); A distancia; USD 54.000 - 143.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

Fully remote position

Shift differential 12.5%

Bonus eligibility

Descripción de la vacante

CVS Health is seeking a Behavioral Health Utilization Management Clinician for a 100% remote, nationwide role. You will review preauthorization requests for behavioral health services, apply evidence-based guidelines, and coordinate decisions with providers while ensuring timely, appropriate care.

The ideal candidate holds an active independent behavioral health license (LPC/LMHC/LCMHC or RN) and has 3+ years of post-licensure behavioral health experience, including crisis management and

Formación

• Active, unrestricted independent behavioral health clinical license in your state of residence (BH license)
• Post-licensure behavioral health experience (3+ years)
• Experience with crisis/ risk assessment and escalation when necessary
• Experience with utilization management or prior authorization processes
• Managed care experience beneficial

Responsabilidades

• 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 and apply clinical judgment to assess risk and determine appropriate interventions
• Support quality, cost-effective care and positive member outcomes
• Collaborate with providers and care teams to facilitate appropriate levels of care

Conocimientos

Independent license

Telephonic work

Crisis management

Clinical judgment

Care coordination

Educación

MSW/Licensed Counseling/PSY

RN with Behavioral Health focus

Herramientas

Utilization Management systems

Prior Authorization experience

Managed Care systems

Descripción del empleo

CVS Health is seeking a Behavioral Health Utilization Management Clinician for a 100% remote, nationwide role. You will review preauthorization requests for behavioral health services, apply evidence-based guidelines, and coordinate decisions with providers while ensuring timely, appropriate care.

The ideal candidate holds an active independent behavioral health license (LPC/LMHC/LCMHC or RN) and has 3+ years of post-licensure behavioral health experience, including crisis management and