Remote Utilization Management Clinician - Behavioral Health

CVS Health; United States; Remote; USD 54,000 - 117,000; Full time

Benefits offered by this job

Bonus eligibility

Comprehensive benefits package

Job summary

CVS Health is hiring for a full-time remote UM Clinician Behavioral Health position. The role follows a Monday–Friday schedule with standard business hours, and no nights, weekends, or holidays. Ideal candidates reside in Mountain, Pacific, or Arizona time zones.

You will assess treatment plans, coordinate services, provide crisis support, determine coverage, and collaborate with providers to ensure optimal patient care and access to benefits.

Qualifications

• Valid unrestricted independent professional behavioral health clinical license to practice per state regulations.
• 3 years of direct clinical practice experience post master’s degree.
• 2 years of crisis intervention experience.
• 3 years of experience working with clients with an autism diagnosis.
• Residential broadband service with internet speeds of at least 25 mbps/3mbps; some reimbursement eligible.

Responsibilities

• Assess appropriateness of treatment plans for ABA services using evidence-based standards.
• Coordinate, monitor, and evaluate options to facilitate healthcare services/benefits for members.
• Provide triage and crisis support.
• Render coverage determinations/recommendations along the continuum of care, including discharge planning.
• Coordinate with providers and other parties to facilitate optimal care.

Skills

Crisis intervention

Autism experience

Clinical license

Education

Master's degree in Behavioral/Mental health or Health Services

Job description

CVS Health is hiring for a full-time remote UM Clinician Behavioral Health position. The role follows a Monday–Friday schedule with standard business hours, and no nights, weekends, or holidays. Ideal candidates reside in Mountain, Pacific, or Arizona time zones.

You will assess treatment plans, coordinate services, provide crisis support, determine coverage, and collaborate with providers to ensure optimal patient care and access to benefits.