Remote Behavioral Health Utilization Specialist

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

Benefits offered by this job

Medical, dental, and vision coverage

Paid time off

Retirement savings options

Wellness programs

Job summary

CVS Health is seeking a Behavioral Health Utilization Management Clinician for a remote role with Louisiana preference and Sunday–Thursday, 8:00 AM–5:00 PM CST. The position supports utilization management, care coordination, and evidence‑based clinical decision making to improve member outcomes.

Required licenses (LA) or psychiatric RN, 3+ years BH experience, EMR familiarity, and a Master's in Behavioral Health (RN option with Bachelor’s in Nursing considered) are desired.

Qualifications

• Active, unrestricted Behavioral Health license in Louisiana (LCSW, LCPC, LMFT, LPCC, LPAT, LPC)
• Active, unrestricted Compact RN license with psychiatric specialty experience
• 3+ years of behavioral health clinical practice experience
• 1+ year of Electronic Medical Record (EMR) documentation experience
• Ability to work Sunday - Thursday, 8:00 AM - 5:00 PM CST, with flexibility for 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 effective discharge planning and transitions of care
• Identify members at risk for poor outcomes and coordinate referrals to additional programs and services
• Promote quality, cost-effective healthcare utilization and positive member outcomes
• Collaborate with internal and external stakeholders to support comprehensive care management

Skills

Behavioral Health license (LA)

Compact RN license (psychiatric)

BH clinical experience

EMR experience

Weekend/weekday CST schedule

Education

Master's degree in Behavioral Health

Bachelor's in Nursing

Job description

CVS Health is seeking a Behavioral Health Utilization Management Clinician for a remote role with Louisiana preference and Sunday–Thursday, 8:00 AM–5:00 PM CST. The position supports utilization management, care coordination, and evidence‑based clinical decision making to improve member outcomes.

Required licenses (LA) or psychiatric RN, 3+ years BH experience, EMR familiarity, and a Master's in Behavioral Health (RN option with Bachelor’s in Nursing considered) are desired.