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[Hiring] Utilization Management – Registered Nurse or Behavioral Health Clinician @CVS Health

Remote, USA Full-time Posted 2025-11-24
This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more. Role Description This is an after hours work at home position. Must work the below schedule: • Thursday and Friday 3pm-1am MT • Saturday and Sunday 11am-9pm MT Must be able to work Holidays. There will be a 12.5% differential for this shift. Utilizes clinical skills to coordinate, document and communicate all aspects of the utilization/benefit management program for preauthorization for mental health services. Applies critical thinking and is knowledgeable in clinically appropriate treatment, evidence based care and clinical practice guidelines for Behavioral Health and/or medical conditions based upon program focus within a call center setting. Qualifications • 3+ years of post clinical licensure experience in behavioral health • 3+ years knowledge of mental health and substance abuse disorders • Valid unrestricted independent professional behavioral health clinical license to practice per state regulations in the state they reside in (one or more or equivalent is required: LPC, LMFT, LCSW, LMHC, LCMHC, LICSW, LISW, Clinical Psychologist or RN) • Required to use a residential broadband service with internet speeds of at least 25 mbps/3mbps in order to ensure sufficient speed to adequately perform work duties • Must be able to talk on the telephone and type at the same time, this is a queue based job Requirements • Direct clinical experience in a hospital setting or prior Utilization Management experience (preferred) • If RN, Bachelor's degree in nursing required with emphasis on Behavioral Health or Psychology • If BH-licensed, Masters degree in Social Work, Counseling, Psychology required Benefits • Affordable medical plan options • 401(k) plan (including matching company contributions) • Employee stock purchase plan • No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching • Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility Apply tot his job Apply To this Job

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