Utilization Management Clinical Consultant (Tuesday - Saturday)

CVS Health Corporation; Louisiana (MO); Hybrid; USD 74,530,000 - 160,864,000; Full time

Benefits offered by this job

Medical, dental, vision insurance

Paid time off

Retirement options

Job summary

CVS Health Corporation is seeking a licensed behavioral health clinician (LCSW, LCPC, or RN with psychiatric experience) to join our care coordination team. The role focuses on utilizing clinical skills to coordinate, document and communicate utilization/benefit management for members.

The schedule is Tuesday through Saturday, 8am–5pm CST, with flexibility to work outside standard hours based on business needs. A valid LA license or equivalent psychiatric specialty is required.

Qualifications

• Independent Behavioral Health license or unrestricted RN license with psychiatric specialty.
• 3+ years clinical practice in psychiatric or behavioral health settings.
• 1+ year EMR documentation experience.
• Reliable high-speed internet access.
• Willingness to work Tue-Sat, 8am–5pm CST, with schedule flexibility.

Responsibilities

• Coordinate, monitor and evaluate options to facilitate appropriate healthcare services/benefits for members.
• Provide triage and crisis support.
• Gather clinical information and apply guidelines to render coverage recommendations along the continuum of care.
• Coordinate with providers to facilitate optimal care and treatment.
• Identify high-risk members and coordinate referrals to integrate with other programs.
• Promote quality and effectiveness of healthcare utilization.
• Consult with internal and external stakeholders in utilization/benefits management.

Skills

Behavioral health license

RN license

Clinical practice 3+ yrs

EMR documentation

Reliable internet

Flexible schedule

Education

Independent Behavioral Health licensure (LCSW/LPCC/LMFT/LP)

RN with psychiatric specialty

Tools

EMR systems

Job description

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.

Schedule is Tuesday-Saturday with flexibility to work outside of the standard schedule based on business needs

LCSW, LCPC, RN with experience in psychiatric setting required.

Utilizes clinical skills to coordinate, document and communicate all aspects of the utilization/benefit management program.

Applies critical thinking and is knowledgeable in clinically appropriate treatment, evidence based care and clinical practice guidelines for Behavioral Health and/or medical conditions based upon program focus.

Utilizes clinical experience and skills in a collaborative process to assess appropriateness of treatment plans across levels of care, apply evidence based standards and practice guidelines to treatment where appropriate.

• Coordinate, monitor and evaluate options to facilitate appropriate healthcare services/benefits for members.
• Provides triage and crisis support.
• Gathers clinical information and applies the appropriate clinical criteria/guideline, policy, procedure and clinical judgment to render coverage. determination/recommendation along the continuum of care facilitates including effective discharge planning.
• Coordinates with providers and other parties to facilitate optimal care/treatment.
• Identifies members at risk for poor outcomes and facilitates referral opportunities to integrate with other products, services and/or programs.
• Identifies opportunities to promote quality effectiveness of healthcare services and benefit utilization.
• Consults and lends expertise to other internal and external constituents in the coordination and administration of the utilization/benefit management function.

Required Qualifications

• Independent Behavioral Health clinician License or an Unrestricted Registered Nurse (RN) License either within the state of LA or Compacted 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
• Must have reliable High Speed internet access
• Work Schedule is Tuesday - Saturday, 8am - 5pm CST. Must have flexibility to work outside of the standard schedule based on business needs, including occasional rotating weekend and holiday schedules.

Preferred Qualifications

• Prefers someone who resides in Louisiana
• Managed care/utilization review experience preferred
  Experience in a behavioral health inpatient setting
• Ability to multitask, prioritize and effectively adapt to a fast-paced changing environment
• Position requires proficiency with computer skills which includes navigating multiple systems and keyboarding

Education

• Master's Level of Education resulting in independent Behavioral Health licensure (LCSW, LPCC, LMFT, LPAT, LP) or a Bachelor's Level of Education resulting in a Registered Nurse (RN) with an unrestricted state license with psychiatric specialty experience

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.

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.

Great benefits for great people

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: 10/07/2026

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