Remote Behavioral Health Utilization Specialist

CVS Health; Baton Rouge (LA); Remote; USD 36,000 - 77,000; Full time

Benefits offered by this job

Remote flexibility

Competitive benefits

Job summary

CVS Health is seeking a Behavioral Health Utilization Management Clinician to join our remote-enabled team serving Louisiana members. The role supports evidence-based behavioral health services, medical necessity reviews, and care coordination within a Sunday–Thursday CST schedule.

The position requires a current Louisiana behavioral health license or psychiatric RN specialty, 3+ years in relevant practice, and EMR documentation experience. Flexible weekends/holidays may be required.

Qualifications

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

Responsibilities

• Review behavioral health services and treatment plans for medical necessity and appropriateness
• Apply evidence-based guidelines and clinical best practices across levels of care
• Coordinate utilization management decisions with providers and care teams
• Provide triage support and crisis intervention as needed
• Facilitate discharge planning and transitions of care
• Identify at-risk members and coordinate referrals to programs
• Promote cost-effective utilization and positive member outcomes
• Collaborate with internal and external stakeholders to support care management

Skills

Behavioral health license

EMR documentation experience

Clinical practice experience

Sunday-Thursday availability

Education

Master's degree (Behavioral Health clinicians)

Bachelor’s degree in Nursing

Tools

EMR systems

Job description

CVS Health is seeking a Behavioral Health Utilization Management Clinician to join our remote-enabled team serving Louisiana members. The role supports evidence-based behavioral health services, medical necessity reviews, and care coordination within a Sunday–Thursday CST schedule.

The position requires a current Louisiana behavioral health license or psychiatric RN specialty, 3+ years in relevant practice, and EMR documentation experience. Flexible weekends/holidays may be required.