Remote Behavioral Health Utilization Consultant

CVS Health Corporation; Montpelier (VT); Remote; USD 54,000 - 117,000; Full time

Job summary

CVS Health Corporation is seeking a Behavioral Health Utilization Management Clinician for remote work with a Louisiana preference. The role focuses on reviewing services, applying guidelines, and coordinating care to ensure medically necessary behavioral health treatment.

The position requires an active Louisiana behavioral health license and an unrestricted RN license with psychiatric experience, plus 3+ years of clinical practice and 1+ year EMR documentation experience.

Qualifications

• Active Louisiana behavioral health license (LCSW, LCPC, LMFT, LPCC, LPAT, LPC)
• Active, unrestricted Compact RN license with psychiatric specialty
• 3+ years behavioral health clinical practice experience
• 1+ year EMR documentation experience
• Sunday–Thursday, 8:00 AM–5:00 PM CST with possible 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 members at risk and coordinate referrals to additional programs and services
• Promote quality and cost-effective utilization and outcomes
• Collaborate with internal and external stakeholders to support comprehensive care management

Skills

Behavioral health licensure

RN with psych specialty

EMR documentation

Clinical practice experience

Sunday-Thursday availability

Education

Master's degree (behavioral health)

Tools

EMR systems

Job description

CVS Health Corporation is seeking a Behavioral Health Utilization Management Clinician for remote work with a Louisiana preference. The role focuses on reviewing services, applying guidelines, and coordinating care to ensure medically necessary behavioral health treatment.

The position requires an active Louisiana behavioral health license and an unrestricted RN license with psychiatric experience, plus 3+ years of clinical practice and 1+ year EMR documentation experience.