Remote Behavioral Health Utilization Consultant

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

Benefits offered by this job

Medical, dental, vision

Retirement savings options

Paid time off

Job summary

CVS Health is seeking a Behavioral Health Utilization Management Clinician to support members by evaluating services for medical necessity and coordinating care with providers. This remote role prefers Louisiana licensees and requires Sunday-Thursday scheduling with CST hours.

Responsibilities include crisis triage, discharge planning, and referrals to additional programs, ensuring quality and cost-effective care. Eligible for CVS Health bonus programs and comprehensive benefits.

Qualifications

• Active, unrestricted Behavioral Health license in Louisiana (LCSW, LCPC, LMFT, LPCC, LPAT, LPC) or RN with psychiatric specialty.
• 3+ years of behavioral health clinical practice experience
• Experience with Electronic Medical Records (EMR) documentation
• Ability to work Sunday - Thursday, 8:00 AM - 5:00 PM CST with some weekends/holidays
• Strong collaboration with care teams and stakeholders

Responsibilities

• Review behavioral health services and treatment plans to determine medical necessity and appropriateness 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 at-risk members and coordinate referrals to programs and services
• Promote quality, cost-effective healthcare utilization and positive member outcomes
• Collaborate with internal and external stakeholders to support comprehensive care management

Job description

CVS Health is seeking a Behavioral Health Utilization Management Clinician to support members by evaluating services for medical necessity and coordinating care with providers. This remote role prefers Louisiana licensees and requires Sunday-Thursday scheduling with CST hours.

Responsibilities include crisis triage, discharge planning, and referrals to additional programs, ensuring quality and cost-effective care. Eligible for CVS Health bonus programs and comprehensive benefits.