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.
Utilization Management Clinical Consultant
Location: Work at Home CST
Travel: None
Schedule: Tuesday-Saturday with flexibility to work outside of the standard schedule based on business needs
Position summary:
In this role you will be utilizing clinical experience and skills in a collaborative process to assess appropriate treatment plans across levels of care. Applying evidence-based standards and practice guidelines to treatment where appropriate. Coordinating, monitoring, and evaluating options to facilitate appropriate healthcare services/benefits for members. Identifies members at risk for poor outcomes and facilitates referral opportunities to integrate with other products, services, and/or programs. Providing triage and crisis support. Gathers clinical information and applying the appropriate clinical criteria/guideline, policy, procedure, and clinical judgment to render coverage determination/recommendation along the continuum of care facilitates including effective discharge planning. You will also be coordinating with providers and other parties to facilitate optimal care/treatment. Identifies opportunities to promote quality effectiveness of healthcare services and benefit utilization. Consults and lends expertise to other internal and external constituents in the coordination and administration of the utilization/benefit management function.
Required Qualifications:
- Independent Behavioral Health clinician License either within the state of LA or Compact with psychiatric specialty experience.
- 3+ years clinical practice experience, e.g., psychiatric hospital, residential or behavioral health treatment setting.
- 1+ year Electronic Medical Record documentation experience.
Preferred Qualifications:
- Preference to candidates who reside in Louisiana.
- Managed care/utilization review experience preferred.
- Experience in a behavioral health inpatient setting
- Ability to multitask, prioritize and effectively adapt to a fast-paced changing environment.
High level of technical skills
Education:
Master's Level of Education resulting in independent Behavioral Health licensure (LCSW, LPCC, LMFT, LPAT, LP) with psychiatric specialty experience
Anticipated Weekly Hours
40Time Type
Full timePay Range
The typical pay range for this role is:
$26.01 - $56.14This 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.
Additional details about available benefits are provided during the application process and on Benefits Moments.
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
Skills Required
- Independent behavioral health clinician license or unrestricted Registered Nurse license in Louisiana or a compact state, with psychiatric specialty experience
- At least 3 years of clinical practice experience in a psychiatric hospital, residential, or behavioral health treatment setting
- At least 1 year of electronic medical record documentation experience
- Reliable high-speed internet access
- Ability to work Tuesday through Saturday, 8 a.m. to 5 p.m. CST, with flexibility for rotating weekends, holidays, and business needs
- Master's-level education resulting in independent behavioral health licensure, or bachelor's-level education resulting in an unrestricted RN license with psychiatric specialty experience
- Residence in Louisiana
- Managed care or utilization review experience
- Behavioral health inpatient setting experience
- Ability to multitask, prioritize, and adapt to a fast-paced changing environment
- Computer proficiency, including navigating multiple systems and keyboarding
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.
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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.
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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.
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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
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.
