Remote Behavioral Health Utilization Nurse Consultant

CVS Health Corporation; Arizona; Remote; USD 40,000 - 86,000; Full time

Benefits offered by this job

Medical, dental, vision benefits

Paid time off

Retirement plan

Job summary

CVS Health is seeking an experienced Utilization Management Nurse Consultant - Behavioral Health for a fully remote role. The position requires an active RN license and 3+ years in acute behavioral health or substance abuse nursing, with 1+ year in concurrent review or prior authorization.

A 3-week training with full participation is mandatory. The role involves applying evidence-based criteria, coordinating with providers, authorizing care, and documenting thoroughly.

Qualifications

• Active unrestricted state RN license in state of residence.
• 3+ years of acute behavioral health and/or substance abuse clinical nursing experience.
• 1+ year of concurrent review or prior authorization preferably in Behavioral Health and Substance Abuse.
• Commitment to attend a 3-week training (Mon–Fri) with 100% participation.
• Educational requirement: Associate's degree in nursing (RN); BSN preferred.

Responsibilities

• Apply clinical judgment and evidence-based criteria to review inpatient and outpatient services.
• Collaborate with providers, authorize care, and escalate cases when needed.
• Maintain accurate documentation across multiple systems and software.
• Occasional on-call rotational coverage on weekends and holidays.

Skills

Critical thinking

Clinical judgment

Communication

Documentation

Education

Associate's degree in nursing (RN)

BSN preferred

Job description

CVS Health is seeking an experienced Utilization Management Nurse Consultant - Behavioral Health for a fully remote role. The position requires an active RN license and 3+ years in acute behavioral health or substance abuse nursing, with 1+ year in concurrent review or prior authorization.

A 3-week training with full participation is mandatory. The role involves applying evidence-based criteria, coordinating with providers, authorizing care, and documenting thoroughly.