Utilization Management Clinical Consultant (Monday - Friday)
About The Position
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. Behavioral Health Utilization Management Clinician Remote | Louisiana Preferred | Monday-Friday/Tuesday-Saturday Schedule Are you a licensed Behavioral Health professional or Psychiatric RN looking to make a meaningful impact on members' mental health outcomes? Join our Utilization Management team and play a critical role in ensuring members receive appropriate, evidence-based behavioral health services while supporting quality care and effective treatment planning.
Requirements
- 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 Monday - Friday, 8:00 AM to 5:00 PM Central Standard Time (CST)/Tuesday - Saturday, 8:00 AM – 5:00 PM Central Standard Time (CST), with flexibility for occasional weekends and holidays
Nice To Haves
- 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
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
- dental
- vision coverage
- paid time off
- retirement savings options
- wellness programs
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
