Remote Behavioral Health Utilization Specialist

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

Benefits offered by this job

Remote flexibility

Benefits package

Job summary

CVS Health is seeking a Behavioral Health Utilization Management Clinician for a remote role with Louisiana preferred. You will review plans, apply guidelines, coordinate decisions, and support discharge planning to ensure safe, appropriate care for members.

This full-time position requires a licensed behavioral health professional or psychiatric-registered nurse with EMR experience and CST hours Sunday through Thursday. CVS offers comprehensive benefits and a collaborative team environment.

Qualifications

• Active unrestricted Behavioral Health license in Louisiana (LCSW, LCPC, LMFT, LPCC, LPAT, LPC) or active unrestricted Compact RN with psychiatric specialty
• 3+ years of behavioral health clinical practice (e.g., psychiatric hospital, residential treatment, or behavioral health settings)
• 1+ year of EMR documentation experience
• Full-time availability 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 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

Compact RN license

EMR documentation

Education

Master's degree

Bachelor's Degree in Nursing

Job description

CVS Health is seeking a Behavioral Health Utilization Management Clinician for a remote role with Louisiana preferred. You will review plans, apply guidelines, coordinate decisions, and support discharge planning to ensure safe, appropriate care for members.

This full-time position requires a licensed behavioral health professional or psychiatric-registered nurse with EMR experience and CST hours Sunday through Thursday. CVS offers comprehensive benefits and a collaborative team environment.