Remote Behavioral Health Utilization Specialist

CVS Health; Columbus (OH); Remote; USD 54,000 - 143,000; Full time

Benefits offered by this job

Shift differential 12.5%

Job summary

CVS Health is seeking a Behavioral Health Utilization Management Clinician for a 100% remote, nationwide role. You will review preauthorization requests, coordinate decisions, and manage crisis calls with clinical judgment to ensure timely, appropriate behavioral health services.

This full-time position offers a 12.5% shift differential and benefits. Candidates must hold an active behavioral health license and have 3+ years of post-licensure experience in mental health or substance use

Qualifications

• Active, unrestricted independent behavioral health clinical license in your state of residence.
• 3+ years of post-licensure behavioral health experience.
• 3+ years of experience with mental health and substance use disorders.
• Ability to manage telephonic and computer-based work simultaneously.
• Hospital-based behavioral health experience.
• Utilization Management or Prior Authorization experience.
• Managed Care experience.
• Fully remote position available nationwide with a 12.5% shift differential.

Responsibilities

• Review preauthorization requests for behavioral health services using evidence-based guidelines and clinical judgment
• Coordinate, document, and communicate utilization management decisions with providers and stakeholders
• Ability to manage crisis calls, apply clinical judgment to assess risk, determine support needs, and coordinate appropriate interventions, including escalation for suicide risk, self-harm concerns, and welfare checks when necessary.
• Apply clinical expertise to support quality, cost-effective care and positive member outcomes
• Work in a fast-paced, queue-based environment while managing multiple priorities
• Collaborate with providers and care teams to facilitate appropriate levels of care

Skills

Behavioral health license

Telephonic work

Crisis management

Utilization management

Managed care

Strong communication

Education

Master's degree in Social Work, Counseling, or Psychology

Bachelor's degree in Nursing with emphasis in Behavioral Health or Psychology

Job description

CVS Health is seeking a Behavioral Health Utilization Management Clinician for a 100% remote, nationwide role. You will review preauthorization requests, coordinate decisions, and manage crisis calls with clinical judgment to ensure timely, appropriate behavioral health services.

This full-time position offers a 12.5% shift differential and benefits. Candidates must hold an active behavioral health license and have 3+ years of post-licensure experience in mental health or substance use