Remote Behavioral Health Utilization Consultant

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

Benefits offered by this job

Remote work flexibility

Comprehensive benefits

Job summary

CVS Health is seeking a Behavioral Health Utilization Management Clinician to support evidence‑based care decisions. This remote role prefers Louisiana licensure and follows a Sunday–Thursday CST schedule.

You will review treatment plans, coordinate with care teams, provide triage and discharge planning to ensure appropriate levels of care across settings. 3+ years clinical experience, EMR experience, and active licenses are required.

Qualifications

• Active, unrestricted Behavioral Health license in Louisiana (LCSW, LCPC, LMFT, LPCC, LPAT, LPC) or Compact RN with psychiatric specialty experience
• 3+ years of behavioral health clinical practice experience (e.g., psychiatric hospital, residential treatment, behavioral health settings)
• 1+ year of EMR documentation experience
• Ability to work Sunday - Thursday, 8:00 AM - 5:00 PM CST, with occasional 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 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

Behavioral Health License

RN License

EMR Experience

3+ Years Experience

Sunday-Thursday Schedule

Education

Master's Degree

RN with Psychiatric Specialty

BSN Considered

Job description

CVS Health is seeking a Behavioral Health Utilization Management Clinician to support evidence‑based care decisions. This remote role prefers Louisiana licensure and follows a Sunday–Thursday CST schedule.

You will review treatment plans, coordinate with care teams, provide triage and discharge planning to ensure appropriate levels of care across settings. 3+ years clinical experience, EMR experience, and active licenses are required.