Utilization Management Clinical Consultant (Tuesday - Saturday)
About The Position
CVS Health is seeking a Behavioral Health Utilization Management Clinician to help members receive appropriate, evidence-based behavioral health services. The role reviews care and treatment plans, supports quality care and effective treatment planning, and promotes positive member outcomes in a remote setting. Louisiana residency is preferred. The position requires a schedule of either Monday through Friday or Tuesday through Saturday, 8:00 a.m. to 5:00 p.m. Central Standard Time, with flexibility for occasional weekends and holidays. The role is full-time, with 40 anticipated weekly hours. The stated hourly pay range is $26.01 to $56.14, with potential eligibility for a CVS Health bonus, commission, or short-term incentive program. The position includes a comprehensive benefits package, subject to eligibility.
Requirements
- Active, unrestricted independent Behavioral Health license in Louisiana (LCSW, LCPC, LMFT, LPCC, LPAT, or LPC), or an active, unrestricted Compact RN license with psychiatric specialty experience.
- At least 3 years of behavioral health clinical practice experience, such as in a psychiatric hospital, residential treatment, or behavioral health treatment setting.
- At least 1 year of Electronic Medical Record (EMR) documentation experience.
- Ability to work either Monday through Friday, 8:00 a.m. to 5:00 p.m. CST, or Tuesday through Saturday, 8:00 a.m. to 5:00 p.m. CST, with flexibility for occasional weekends and holidays.
- A master's degree is required for independently licensed Behavioral Health clinicians.
- Registered Nurses with psychiatric specialty experience and an unrestricted nursing license are also considered; a Bachelor’s Degree in Nursing is specified for this pathway.
Nice To Haves
- Louisiana residency is 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.
Responsibilities
- 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.
Benefits
- Medical coverage
- Dental coverage
- Vision coverage
- Paid time off
- Retirement savings options
- Wellness programs
- Other resources, based on eligibility
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What This Job Offers
Job Type
Full-time
