Remote Behavioral Health Utilization Consultant

CVS Health; Bristol (RI); Remote; USD 36,000 - 77,000; Full time

Benefits offered by this job

Remote flexibility

Comprehensive benefits

Job summary

CVS Health is seeking a Behavioral Health Utilization Management Clinician for a remote role with Louisiana preference. The position involves ensuring appropriate, evidence-based behavioral health services, coordinating care, and supporting discharge planning in a Sunday–Thursday CST schedule.

Ideal candidates hold an active BH license or Compact RN with psychiatric experience and have 3+ years in behavioral health settings, plus EMR documentation experience.

Qualifications

• Active, unrestricted BH license in Louisiana or Compact RN with psychiatric specialty.
• 3+ years of behavioral health clinical practice.
• 1+ year of Electronic Medical Record (EMR) documentation experience.
• Availability Sunday–Thursday, 8:00 AM–5:00 PM CST.

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

BH license

RN license

EMR experience

Clinical practice 3+ yrs

Sunday–Thursday CST

Education

Master's degree in Behavioral Health

Nursing degree

Tools

EMR systems

Job description

CVS Health is seeking a Behavioral Health Utilization Management Clinician for a remote role with Louisiana preference. The position involves ensuring appropriate, evidence-based behavioral health services, coordinating care, and supporting discharge planning in a Sunday–Thursday CST schedule.

Ideal candidates hold an active BH license or Compact RN with psychiatric experience and have 3+ years in behavioral health settings, plus EMR documentation experience.