Remote Behavioral Health Utilization Consultant

CVS Health Corporation; United States; Remote; USD 36,000 - 77,000; Full time

Benefits offered by this job

Remote work flexibility

Comprehensive benefits

Bonus eligibility

Job summary

CVS Health Corporation is seeking a Behavioral Health Utilization Management Clinician for remote work with a Louisiana preference. You'll review services, apply guidelines, coordinate with care teams, and provide crisis support.

The role requires a Louisiana license (LCSW/LCPC/LMFT/LPCC/LPAT/LPC) or compact RN with psychiatric experience, plus 3+ years of clinical practice and 1+ year EMR documentation experience. Sunday–Thursday, 8:00 AM–5:00 PM CST, with some weekends/holidays.

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.
• 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 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 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

EMR documentation

Clinical practice experience

Schedule flexibility

Education

Master's degree in Behavioral Health

Licensed RN with psychiatric specialty

Tools

EMR systems

Job description

CVS Health Corporation is seeking a Behavioral Health Utilization Management Clinician for remote work with a Louisiana preference. You'll review services, apply guidelines, coordinate with care teams, and provide crisis support.

The role requires a Louisiana license (LCSW/LCPC/LMFT/LPCC/LPAT/LPC) or compact RN with psychiatric experience, plus 3+ years of clinical practice and 1+ year EMR documentation experience. Sunday–Thursday, 8:00 AM–5:00 PM CST, with some weekends/holidays.