Utilization Management Clinical Consultant (Sunday Thursday)

Posted 3 Days Ago
Be an Early Applicant
27 Locations
In-Office or Remote
26-56 Hourly
Mid level
Fitness • Healthtech • Retail • Pharmaceutical
The Role
Reviews behavioral health services and treatment plans for medical necessity, applies evidence-based utilization guidelines, coordinates decisions with providers, supports crisis intervention and discharge planning, identifies members needing additional services, and promotes quality, cost-effective care. The role collaborates with care teams and stakeholders to improve behavioral health outcomes and transitions of care.
Summary Generated by Built In

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 | Sunday - Thursday 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.

What You'll Do

  • 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

WHAT YOU BRING – REQUIRED

  • 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 Sunday - Thursday, 8:00 AM – 5:00 PM Central Standard Time (CST), with flexibility for occasional weekends and holidays

Preferred Qualifications

  • 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

Education

  • 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)

Why Join Us?

  • Opportunity to improve behavioral health outcomes for members across the continuum of care

  • Collaborative environment with providers, care managers, and clinical experts

  • Apply your clinical expertise in a meaningful, non-traditional care setting

  • Influence quality, access, and effectiveness of behavioral health services

  • Remote flexibility with a supportive team culture

If you're passionate about behavioral health, utilization management, and helping members access the right level of care at the right time, we'd love to hear from you. Apply today!

 

Anticipated Weekly Hours

40

Time Type

Full time

Pay Range

The typical pay range for this role is:

$26.01 - $56.14

This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls.  The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors.  This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. 
 

Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.

Great benefits for great people

We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families.

This full‑time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well‑being of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility.


Additional details about available benefits are provided during the application process and on
Benefits Moments.

We anticipate the application window for this opening will close on: 10/24/2026

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

Skills Required

  • Active, unrestricted independent Behavioral Health license in Louisiana, such as LCSW, LCPC, LMFT, LPCC, LPAT, or LPC
  • Active, unrestricted Compact RN license with psychiatric specialty experience
  • At least 3 years of behavioral health clinical practice experience
  • At least 1 year of Electronic Medical Record documentation experience
  • Ability to work Sunday through Thursday, 8:00 AM to 5:00 PM CST, with flexibility for occasional weekends and holidays
  • Louisiana residency
  • Managed Care, Utilization Review, or Utilization Management experience
  • Behavioral health inpatient experience
  • Licensed Addiction Counselor certification
  • Strong multitasking, prioritization, and organizational skills
  • Proficiency navigating multiple systems and applications in a fast-paced environment
  • Master's degree for independently licensed Behavioral Health clinicians
  • Bachelor's Degree in Nursing for Registered Nurses

CVS Health Compensation & Benefits Highlights

The following summarizes recurring compensation and benefits themes identified from responses generated by popular LLMs to common candidate questions about CVS Health and has not been reviewed or approved by CVS Health.

  • Healthcare Strength — Health coverage includes medical, dental, and vision with HSA-eligible options, free preventive care, virtual care, and access to MinuteClinic services. Mental-health resources such as counseling support are emphasized, and coverage is often considered solid for full-time colleagues.
  • Retirement Support — A dollar-for-dollar 401(k) match up to 5% after one year and an Employee Stock Purchase Plan are consistently highlighted in Total Rewards materials. Feedback suggests retirement programs are a meaningful strength within the overall package.
  • Wellbeing & Lifestyle Benefits — Wellbeing offerings include up to 20 no-cost counseling sessions per issue, backup care, tuition assistance, and substantial in-store discounts, alongside broader wellness tools. These everyday perks expand value beyond base pay and can be especially meaningful for full-time schedules.

CVS Health Insights

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The Company
HQ: Woonsocket, RI
119,959 Employees
Year Founded: 1963

What We Do

CVS Health is the leading health solutions company that delivers care in ways no one else can. We reach people in more ways and improve the health of communities across America through our local presence, digital channels and our nearly 300,000 dedicated colleagues – including more than 40,000 physicians, pharmacists, nurses and nurse practitioners. Wherever and whenever people need us, we help them with their health – whether that’s managing chronic diseases, staying compliant with their medications, or accessing affordable health and wellness services in the most convenient ways. We help people navigate the health care system – and their personal health care – by improving access, lowering costs and being a trusted partner for every meaningful moment of health. And we do it all with heart, each and every day.

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