Remote Behavioral Health Utilization Specialist

CVS Health; Montana; Remote; USD 36,000 - 77,000; Full time

Job summary

CVS Health is seeking a Behavioral Health Utilization Management Clinician for a remote role, preferably Louisiana-based. You will review services for medical necessity, apply guidelines, and coordinate decisions with care teams across settings. This position emphasizes crisis triage, discharge planning, and referrals to ensure appropriate, evidence-based care.

Remote schedule supports weekends as needed. The role requires an unrestricted BH license in Louisiana or an RN with psychiatric

Qualifications

• 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
• 1+ year of EMR documentation experience
• Ability to work Sunday–Thursday, 8:00 AM–5:00 PM CST, with occasional weekends/holidays

Responsibilities

• 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 discharge planning and transitions of care.
• Identify members at risk and coordinate referrals to additional programs and services.
• Promote high-quality, cost-effective healthcare utilization and positive member outcomes.
• Collaborate with internal and external stakeholders to support comprehensive care management.

Skills

Behavioral Health license

RN license with psych specialty

Clinical practice experience

EMR documentation experience

Sunday-Thursday CST availability

Education

Master's degree in Behavioral Health

Bachelor's degree in Nursing

Job description

CVS Health is seeking a Behavioral Health Utilization Management Clinician for a remote role, preferably Louisiana-based. You will review services for medical necessity, apply guidelines, and coordinate decisions with care teams across settings. This position emphasizes crisis triage, discharge planning, and referrals to ensure appropriate, evidence-based care.

Remote schedule supports weekends as needed. The role requires an unrestricted BH license in Louisiana or an RN with psychiatric