Remote Behavioral Health Utilization Consultant

CVS Health; Central City (CO); Remote; USD 36,000 - 77,000; Full time

Benefits offered by this job

Medical Insurance

Dental Insurance

Vision Coverage

Paid Time Off

Retirement Savings

Wellness Programs

Job summary

CVS Health is seeking a Behavioral Health Utilization Management Clinician for a remote role with Louisiana preference. The position supports utilization management decisions and care coordination across teams, requires a masters in behavioral health and a BH or psychiatric RN license, and offers a Sunday–Thursday CST schedule.

You will review services, manage crises, assist discharge planning, and partner with internal and external stakeholders to improve outcomes while maintaining quality and

Qualifications

• Active, unrestricted Behavioral Health license in Louisiana or licensed RN with psychiatric experience.
• 3+ years in behavioral health clinical practice in settings such as psychiatric hospital or behavioral health treatment.
• Experience with Utilization Management and EMR documentation.
• Masters degree required for independently licensed BH clinicians.

Responsibilities

• Review behavioral health services to determine medical necessity and appropriateness of care.
• Coordinate 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 additional programs.
• Promote cost-effective healthcare utilization and positive outcomes.
• Collaborate with stakeholders to support care management.

Skills

BH License LA

Compact RN License

EMR Experience

Utilization Management

Education

Master's degree in Behavioral Health

Bachelor's Degree in Nursing

Tools

EMR Systems

Job description

CVS Health is seeking a Behavioral Health Utilization Management Clinician for a remote role with Louisiana preference. The position supports utilization management decisions and care coordination across teams, requires a masters in behavioral health and a BH or psychiatric RN license, and offers a Sunday–Thursday CST schedule.

You will review services, manage crises, assist discharge planning, and partner with internal and external stakeholders to improve outcomes while maintaining quality and