Remote Behavioral Health Utilization Management Clinician

CVS Health; Arkansas City (KS); Remoto; USD 36.000 - 77.000; Tempo pieno

Descrizione del lavoro

CVS Health is seeking a remote Behavioral Health Utilization Management Clinician to support members in a Sunday–Thursday CST schedule from Louisiana preferences. The role requires active behavioral health licensure in LA or a Compact RN with psychiatric experience, plus 3+ years of clinical practice and 1+ year EMR documentation experience.

Responsibilities include reviewing services for medical necessity, applying guidelines, coordinating decisions with care teams, providing crisis triage, and

Competenze

• 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 (psychiatric hospital, residential treatment, behavioral health treatment settings)
• 1+ year of Electronic Medical Record (EMR) documentation experience
• Ability to work Sunday–Thursday, 8:00 AM–5:00 PM CST, with flexibility for occasional weekends and holidays

Mansioni

• 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

Conoscenze

Behavioral health licensure

RN license (psychiatric)

EMR documentation experience

Clinical practice 3+ years

Formazione

Master's degree in Behavioral Health

Bachelor's degree in Nursing

Descrizione del lavoro

CVS Health is seeking a remote Behavioral Health Utilization Management Clinician to support members in a Sunday–Thursday CST schedule from Louisiana preferences. The role requires active behavioral health licensure in LA or a Compact RN with psychiatric experience, plus 3+ years of clinical practice and 1+ year EMR documentation experience.

Responsibilities include reviewing services for medical necessity, applying guidelines, coordinating decisions with care teams, providing crisis triage, and