Utilization Management Clinician Behavioral Health

Clinical Careers Page(1 month ago)

RemoteFull TimeMedior$54,095 - $155,538Behavioral Health

About this role

A fully remote Behavioral Health Utilization Management Clinician at CVS Health who applies clinical judgment to coordinate and document utilization and benefit management for members. The role focuses on assessing treatment appropriateness across levels of care, applying evidence-based guidelines, and facilitating care coordination and discharge planning during weekday business hours.

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Required Skills

Clinical Assessment
Utilization Review
Care Coordination
Crisis Triage
Case Management
Discharge Planning
Evidence-Based Care
Documentation
Managed Care
EHR Navigation

Qualifications

Master's Degree in Behavioral/Mental Health or Health Services
Unencumbered Behavioral Health Clinical License (LMSW, LCSW, LISW, LPC or comparable)
Registered Nurse Licensure with Psychiatric Specialty

About Clinical Careers Page

cvshealth.com

CVS Health is America's leading health solutions company, providing integrated services across retail pharmacy (CVS Pharmacy), pharmacy benefits management (CVS Caremark), and health insurance (Aetna). The company offers pharmacy services, health plans, clinical care (including MinuteClinic), and health-and-wellness programs for consumers, employers, and government payers. By combining a large national retail footprint with claims processing, care management, and clinical services, CVS Health aims to coordinate care, lower costs, and improve health outcomes. Businesses and consumers use its solutions for medication management, plan administration, and in-person and virtual care.

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