Utilization Management Clinical Consultant (Sunday Thursday)

CVS Health Corporation; Louisiana (MO); Hybrid; USD 36,000 - 77,000; Full time

Benefits offered by this job

Medical coverage

Dental coverage

Vision coverage

Paid time off

Retirement savings options

Wellness programs

Eligibility-based resources

Job summary

CVS Health Corporation seeks a Behavioral Health Utilization Management Clinician. This remote role prefers Louisiana residency and requires Sunday–Thursday, 8:00 AM–5:00 PM CST. You will review treatment plans, apply guidelines, coordinate with teams, and support crisis intervention and transitions of care.

Ideal candidates hold a LA behavioral health license or psychiatric RN with EMR experience and 3+ years in behavioral health settings, with strong collaboration skills across care teams.

Qualifications

• Active, unrestricted behavioral health license (Louisiana) or an unrestricted RN license with psychiatry experience.
• 3+ years clinical behavioral health practice in settings such as psychiatric hospital or residential treatment.
• 1+ year EMR documentation experience and ability to work a Sunday–Thursday schedule.

Responsibilities

• Review behavioral health services and treatment plans for medical necessity.
• Apply evidence-based guidelines across levels of care and coordinate with care teams.
• Provide crisis triage and assist with discharge planning and transitions of care.
• Identify at-risk members and coordinate referrals to programs and services.
• Collaborate with internal/external stakeholders to support care management.

Skills

Behavioral Health License (LA)

Compact RN license (psych)

EMR documentation experience

3+ years clinical practice

Sunday-Thursday CST availability

Education

Master's degree in Behavioral Health

Bachelor's Degree in Nursing

Job description

Behavioral Health Utilization Management Clinician

Remote | Louisiana Preferred | Sunday - Thursday Schedule

We're building a world of health around every individual - shaping a more connected, convenient and compassionate health experience. At CVS Health®, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger - helping to simplify health care one person, one family and one community at a time.

What You’ll Do

• 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

What You Bring - Required

• Active, unrestricted independent Behavioral Health license in Louisiana (LCSW, LCPC, LMFT, LPCC, LPAT, LPC) or
• Active, unrestricted Compact RN license with psychiatric specialty experience
• 3+ years of behavioral health clinical practice experience, such as:
• Psychiatric hospital
• Residential treatment
• Behavioral health treatment settings
• 1+ year of Electronic Medical Record (EMR) documentation experience
• Ability to work Sunday - Thursday, 8:00 AM - 5:00 PM Central Standard Time (CST), with flexibility for occasional weekends and holidays

Preferred Qualifications

• Louisiana residency strongly preferred
• Managed Care, Utilization Review, or Utilization Management experience
• Behavioral health inpatient experience
• Licensed Addiction Counselor (LAC) certification
• Strong multitasking, prioritization, and organizational skills
• Proficiency navigating multiple systems and applications in a fast-paced environment

Education

Master's degree required for independently licensed Behavioral Health clinicians

Registered Nurse with psychiatric specialty experience and unrestricted nursing license also considered (Bachelor's Degree in Nursing)

Why Join Us?

Opportunity to improve behavioral health outcomes for members across the continuum of care

Collaborative environment with providers, care managers, and clinical experts

Apply your clinical expertise in a meaningful, non-traditional care setting

Influence quality, access, and effectiveness of behavioral health services

Remote flexibility with a supportive team culture

Work Details

Anticipated Weekly Hours: 40

Time Type: Full time

Pay Range

The typical pay range for this role is:

$26.01 - $56.14

This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above.

Benefits

• Medical coverage
• Dental coverage
• Vision coverage
• Paid time off
• Retirement savings options
• Wellness programs
• Other resources, based on eligibility

Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.

We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families.

This full‑time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well‑being of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility.

Additional details about available benefits are provided during the application process and on Benefits Moments.

We anticipate the application window for this opening will close on: 10/24/2026

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local