Utilization Management Clinician Behavioral Health
CVS Health•Washington, DC
•$60,522 - $142,576•Remote
About The Position
Join a collaborative team where your clinical expertise directly impacts member outcomes. As a Behavioral Health Utilization Management Clinician, you’ll use your clinical judgment and evidence-based practices to ensure members receive appropriate, high-quality care across levels of treatment. This is a fast-paced, queue-based role ideal for clinicians who enjoy critical thinking, care coordination, and making a meaningful difference.
Requirements
- Active, unrestricted independent clinical license (LPC, LCSW, LMFT, LMHC, or RN with 5 years of behavioral health experience)
- 3+ years of behavioral health experience
- Strong knowledge of mental health and substance use disorders
- Ability to multitask (talk on phone and document simultaneously) in a queue-based environment
- Availability to work EST hours listed above
Nice To Haves
- Post-master’s direct clinical experience (hospital, outpatient, or ambulatory settings)
- Managed care or utilization review experience
- Crisis intervention experience
Responsibilities
- Review and evaluate treatment plans using evidence-based guidelines
- Coordinate care and facilitate access to appropriate behavioral health services
- Conduct triage and provide crisis support as needed
- Collaborate with providers to optimize treatment outcomes
- Identify at-risk members and connect them with additional resources and programs
- Apply clinical criteria, policy, and professional judgment to make coverage recommendations
Benefits
- medical
- dental
- vision coverage
- paid time off
- retirement savings options
- wellness programs
Stand Out From the Crowd
Upload your resume and get instant feedback on how well it matches this job.
Upload and Match Resume
What This Job Offers
Job Type
Full-time
Career Level
Mid Level
