Remote Behavioral Health Utilization Specialist

CVS Health; Louisiana (MO); Hybrid; USD 36,000 - 77,000; Full time

Benefits offered by this job

Remote work flexibility

Comprehensive benefits

Bonus eligibility

Job summary

CVS Health is seeking a licensed Behavioral Health professional or Psychiatric RN to join our Utilization Management team. This remote role focuses on ensuring appropriate, evidence-based behavioral health services and coordinating care across providers.

The position supports quality care and effective treatment planning for members. The ideal candidate has 3+ years of behavioral health clinical practice, EMR documentation experience, and is available Monday–Friday or Tuesday–Saturday CST with

Qualifications

• Active, unrestricted behavioral health license in Louisiana or an unrestricted compact RN license with psychiatric experience.
• 3+ years of behavioral health clinical practice in settings like psychiatric hospitals or residential treatment.
• 1+ year of EMR documentation experience.

Responsibilities

• Review services and treatment plans to determine medical necessity and appropriateness of care.
• Apply guidelines and best practices across multiple levels of care.
• Coordinate utilization management decisions with providers and care teams.
• Provide triage support and crisis intervention as needed.
• Assist discharge planning and transitions of care.
• Identify at-risk members and coordinate referrals to programs.
• Support cost-effective, high-quality utilization and outcomes.
• Collaborate with stakeholders to support care management.

Skills

Behavioral health license

RN license with psychiatric specialty

EMR documentation experience

Education

Master's degree in Behavioral Health (or equivalent)

Nursing degree (Bachelor's) for RN pathway

Tools

EMR systems

Job description

CVS Health is seeking a licensed Behavioral Health professional or Psychiatric RN to join our Utilization Management team. This remote role focuses on ensuring appropriate, evidence-based behavioral health services and coordinating care across providers.

The position supports quality care and effective treatment planning for members. The ideal candidate has 3+ years of behavioral health clinical practice, EMR documentation experience, and is available Monday–Friday or Tuesday–Saturday CST with