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 colleagues who care deeply, innovate with purpose, hold themselves accountable and prioritize safety and quality in everything they do.
Behavioral Health Utilization Management Clinician
100% Remote | Nationwide | Shift Differential Eligible
As a licensed Behavioral Health professional, you'll join our Utilization Management team to ensure members receive timely, appropriate behavioral health services while making a meaningful impact on outcomes.
Schedule
- Saturday and Sunday 12pm-10pm MT (2pm-midnight EST)
- Thursday-Friday 3p-1am MT (5pm-3am EST)
- Must be available to work holidays
- 12.5% shift differential included
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
- Manage crisis calls, apply clinical judgment to assess risk, determine support needs, and coordinate appropriate interventions
- 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
Requirements
- Active, unrestricted independent behavioral health clinical license in your state of residence (LCSW, LICSW, LISW, LMSW, LPC, LMHC, LCMHC, LMFT, Clinical Psychologist, RN)
- 3+ years of post-licensure behavioral health experience
- 3+ years of experience working with mental health and substance use disorders
- Ability to effectively manage telephonic and computer-based work simultaneously
- High-speed residential internet service (minimum 25 Mbps download / 3 Mbps upload)
Preferred Qualifications
- Hospital-based behavioral health experience
- Utilization Management or Prior Authorization experience
- Managed Care experience
Education
- Master's degree in Social Work, Counseling, or Psychology (for Behavioral Health Clinicians)
- Bachelor's degree in Nursing with an emphasis in Behavioral Health or Psychology (for Registered Nurses)
Benefits
- Fully remote position available anywhere in the U.S.
- Additional 12.5% shift differential
- Opportunity to apply your clinical expertise in a non-traditional setting
- Meaningful work that improves access to quality behavioral health care
- Collaborative, mission-driven team environment
Pay Range
- $54,095.00 - $142,576.00
Anticipated Weekly Hours
- 40
Time Type
- Full time