Remote Clinical Utilization Consultant

CVS Health; Austin (TX); 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 an Utilization Management Clinical Consultant to apply clinical expertise in coordinating care and ensuring appropriate benefits across care levels. This role leverages evidence-based guidelines, triage, crisis support, and collaboration with providers to optimize member care.

The position is full-time, work-at-home ( CST), 40 hours per week, with a schedule Tue-Sat and flexibility. Requires independent Behavioral Health licensure and 3+ years clinical practice; EMR

Qualifications

• Independent Behavioral Health clinician License either within the state of LA or Compact with psychiatric specialty experience.
• 3+ years clinical practice experience, e.g., psychiatric hospital, residential or behavioral health treatment setting.
• 1+ year Electronic Medical Record documentation experience.

Responsibilities

• Assess appropriate treatment plans across levels of care using evidence-based standards and guidelines.
• Coordinate, monitor, and evaluate options to facilitate healthcare services/benefits for members.
• Provide triage and crisis support; render coverage determinations/recommendations; coordinate with providers and other stakeholders.

Education

Master's Level of Education resulting in independent Behavioral Health licensure (LCSW, LPCC, LMFT, LP) with psychiatric specialty experience

Job description

CVS Health is seeking an Utilization Management Clinical Consultant to apply clinical expertise in coordinating care and ensuring appropriate benefits across care levels. This role leverages evidence-based guidelines, triage, crisis support, and collaboration with providers to optimize member care.

The position is full-time, work-at-home ( CST), 40 hours per week, with a schedule Tue-Sat and flexibility. Requires independent Behavioral Health licensure and 3+ years clinical practice; EMR