Utilization Management Clinical Consultant – Tuesday, Saturday

Job not on LinkedIn

🔥 16 minutes ago

🏈 Alabama, Alaska, +45 more states – Remote

🏈 Alabama – Remote 🐻 Alaska – Remote 🌵 Arizona – Remote 🏄 California – Remote ⛰️ Colorado – Remote 🦌 Connecticut – Remote 🏛️ District of Columbia – Remote 🐊 Florida – Remote 🌺 Hawaii – Remote 🥔 Idaho – Remote 🌽 Illinois – Remote 🌾 Iowa – Remote 🌪️ Kansas – Remote 🐎 Kentucky – Remote ⚜️ Louisiana – Remote 🦞 Maine – Remote 🦬 Montana – Remote 🌾 Nebraska – Remote 🎰 Nevada – Remote 🗻 New Hampshire – Remote 🏖️ New Jersey – Remote 🌶️ New Mexico – Remote 🗽 New York – Remote 🌲 North Carolina – Remote 🌾 North Dakota – Remote 🏈 Ohio – Remote 🌪️ Oklahoma – Remote 🌲 Oregon – Remote 🦀 Maryland – Remote 🍂 Massachusetts – Remote 🚗 Michigan – Remote ❄️ Minnesota – Remote 🎸 Mississippi – Remote 🏰 Missouri – Remote 🔔 Pennsylvania – Remote ⚓ Rhode Island – Remote 🌴 South Carolina – Remote 🗿 South Dakota – Remote 🎸 Tennessee – Remote 🤠 Texas – Remote ⛷️ Utah – Remote 🍁 Vermont – Remote ⚔️ Virginia – Remote ☕ Washington – Remote ⛰️ West Virginia – Remote 🧀 Wisconsin – Remote 🦬 Wyoming – Remote

💵 $26 - $56 / hour

⏰ Full Time

🟡 Mid-level

🟠 Senior

💼 Consultant

👻 Ghost score 0%

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CVS Health

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1963

🏥 Healthcare

⚕️ Healthcare Insurance

🛒 Retail

Healthcare • Healthcare Insurance • Retail

CVS Health is a leading American healthcare company dedicated to improving health access and affordability. The company focuses on a comprehensive approach that includes health services, health insurance, and pharmacy benefits management. Through its subsidiaries, such as Aetna and CVS Caremark, CVS Health offers a range of services that facilitate wellness, condition management, and affordable prescription drug coverage. CVS Health operates neighborhood pharmacies, provides mail-order pharmacy services, and manages specialty medication programs, aiming to make healthcare convenient and accessible for everyone. Driven by a mission to connect people with essential care services, CVS Health is committed to fostering healthier communities and supporting the wellbeing of all individuals.

📋 Description

• 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

🎯 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 • 1+ year of Electronic Medical Record (EMR) documentation experience • Ability to work Monday–Friday or Tuesday–Saturday, 8:00 AM–5:00 PM Central Standard Time, with flexibility for occasional weekends and holidays • Master's degree required for independently licensed Behavioral Health clinicians • Registered Nurse with psychiatric specialty experience and unrestricted nursing license also considered (Bachelor’s Degree in Nursing) • Managed Care, Utilization Review, or Utilization Management experience preferred • Behavioral health inpatient experience preferred • Licensed Addiction Counselor (LAC) certification preferred • Strong multitasking, prioritization, and organizational skills • Proficiency navigating multiple systems and applications in a fast-paced environment • Louisiana residency strongly preferred

🏖️ Benefits

• Medical coverage • Dental coverage • Vision coverage • Paid time off • Retirement savings options • Wellness programs • Other resources supporting physical, emotional, and financial well-being • Remote flexibility with a supportive team culture • CVS Health bonus, commission or short-term incentive program eligibility