Remote Behavioral Health Utilization Consultant

CVS Health; South Dakota Park (SD); Remote; USD 36,000 - 77,000; Full time

Benefits offered by this job

Comprehensive benefits package

Remote work flexibility

Bonus program

Job summary

CVS Health is seeking a Behavioral Health Utilization Management Clinician for remote work with a preference for Louisiana-based licensure. The role involves reviewing services, coordinating with care teams, triage, and discharge planning, with a focus on evidence-based behavioral health care.

Required are a master’s degree for independent licensure or applicable nursing credentials, and utilization management experience. Remote flexibility and a comprehensive benefits package are included.

Qualifications

• Active, unrestricted Behavioral Health license in Louisiana (LCSW, LCPC, LMFT, LPCC, LPAT, LPC) or
• Active, unrestricted Compact RN license with psychiatric specialty experience
• 3+ years of behavioral health clinical practice experience
• Master’s degree required for independently licensed Behavioral Health clinicians
• Registered Nurse with psychiatric specialty experience and unrestricted nursing license also considered (Bachelor’s Degree in Nursing)
• Remote flexibility with a supportive team culture

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 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

Licensed behavioral health clinician

Psychiatric RN

EMR experience

Utilization management

Crisis intervention

Care coordination

Remote work

Team collaboration

Education

Master’s degree

Nursing degree

Job description

CVS Health is seeking a Behavioral Health Utilization Management Clinician for remote work with a preference for Louisiana-based licensure. The role involves reviewing services, coordinating with care teams, triage, and discharge planning, with a focus on evidence-based behavioral health care.

Required are a master’s degree for independent licensure or applicable nursing credentials, and utilization management experience. Remote flexibility and a comprehensive benefits package are included.