Remote Utilization Management Clinician – Behavioral Health

CVS Health; Central City (KY); Remote; USD 54,000 - 143,000; Full time

Benefits offered by this job

Shift differential

Benefits package

Job summary

CVS Health is seeking a Behavioral Health Utilization Management Clinician to join our remote team nationwide. You will review preauthorization requests, coordinate decisions, and manage crisis calls while ensuring safe, timely, and appropriate behavioral health services for members.

The role requires licensure in your state, a master’s degree in a relevant field, and 3+ years of behavioral health experience, with telephonic and computer-based work in a fast-paced environment.

Qualifications

• Active, unrestricted independent behavioral health license in your state of residence.
• Behavioral Health Clinicians: Master's degree in Social Work, Counseling, or Psychology.
• Registered Nurses: Bachelor's degree in Nursing with emphasis in Behavioral Health or Psychology.
• 3+ years of post-licensure behavioral health experience.
• 3+ years of experience working with mental health and substance use disorders.
• Ability to effectively manage telephonic and computer-based work simultaneously.
• Fully remote position available anywhere in the U.S.

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.
• Ability to manage crisis calls, apply clinical judgment to assess risk, determine support needs, and coordinate interventions, including escalation for suicide risk, self-harm concerns, and welfare checks when necessary.
• 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 facilitate appropriate levels of care.

Skills

Clinical judgment

Telephonic work

Care coordination

Fast-paced environment

Education

Master's degree in Social Work, Counseling, or Psychology

RN: BSN with Behavioral Health or Psychology emphasis

Job description

CVS Health is seeking a Behavioral Health Utilization Management Clinician to join our remote team nationwide. You will review preauthorization requests, coordinate decisions, and manage crisis calls while ensuring safe, timely, and appropriate behavioral health services for members.

The role requires licensure in your state, a master’s degree in a relevant field, and 3+ years of behavioral health experience, with telephonic and computer-based work in a fast-paced environment.