Remote Behavioral Health Utilization Specialist

4062 Aetna Resources, LLC; Utah; Hybrid; USD 54,000 - 143,000; Full time

Benefits offered by this job

Shift differential 12.5%

Fully remote work

Job summary

CVS Health is seeking a Behavioral Health Utilization Management Clinician for a 100% remote role nationwide. The position features a 12.5% shift differential, weekend/evening schedule, and holidays.

You will review preauthorization requests, coordinate decisions with providers, and manage crisis calls with clinical judgment to ensure timely, appropriate BH services. Qualified candidates hold an independent BH license, 3+ years in behavioral health and with 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.
• High-speed residential internet (min 25 Mbps down / 3 Mbps up).

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.
• Manage crisis calls with clinical judgment, assess risk, determine support needs, and coordinate interventions including suicide risk escalation.
• 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 ensure appropriate levels of care.

Skills

BH license

BH experience

SUD experience

Telework multitask

Home internet

Education

MSW/Counseling/Psychology

RN BH emphasis

Job description

CVS Health is seeking a Behavioral Health Utilization Management Clinician for a 100% remote role nationwide. The position features a 12.5% shift differential, weekend/evening schedule, and holidays.

You will review preauthorization requests, coordinate decisions with providers, and manage crisis calls with clinical judgment to ensure timely, appropriate BH services. Qualified candidates hold an independent BH license, 3+ years in behavioral health and with mental health or substance use