Remote Utilization Management Clinician - Behavioral Health

CVS Health; Oklahoma; Remote; USD 54,000 - 143,000; Full time

Benefits offered by this job

12.5% shift differential

Remote position nationwide

Job summary

CVS Health is hiring a Behavioral Health Utilization Management Clinician for a 100% remote, nationwide role. You will review preauthorization requests, coordinate UM decisions, and manage crisis calls while ensuring timely, appropriate behavioral health services to members.

This full-time position offers a 12.5% shift differential and holidays are required. The role requires an active behavioral health license, 3+ years of post-licensure experience with mental health and substance use

Qualifications

• Active, unrestricted behavioral health clinical license in your state of residence.
• 3+ years of post-licensure behavioral health experience in clinical settings.
• 3+ years of experience with mental health and substance use disorders.

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 and assess risk, including escalation for suicide risk, self-harm, and welfare checks.
• 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

Active behavioral health license

3+ years post-licensure experience

3+ years mental health & substance use

Telephonic & computer-based work

Utilization Management / Prior Author.

Managed Care experience

Crisis risk assessment

Education

Master's in Social Work / Counseling / Psychology

RN (with Behavioral Health focus)

Job description

CVS Health is hiring a Behavioral Health Utilization Management Clinician for a 100% remote, nationwide role. You will review preauthorization requests, coordinate UM decisions, and manage crisis calls while ensuring timely, appropriate behavioral health services to members.

This full-time position offers a 12.5% shift differential and holidays are required. The role requires an active behavioral health license, 3+ years of post-licensure experience with mental health and substance use