Utilization Management Clinician, Behavioral Health

CVS Health

Behavioral health utilization clinician reviewing authorizations and coordinating crisis-informed care decisions for CVS Health members. Fully remote nationwide role supporting quality, cost-effective behavioral health outcomes.

Posted 8/12/2026full-timeRemote • Idaho, Utah, Vermont • 🇺🇸 United StatesMid-LevelSenior💰 $54,095 - $142,576 per yearWebsite

Core Competencies

Role fit

Core Competencies

Use this summary to align your resume positioning with the role.

Demonstrates expertise in behavioral health clinical practices, including crisis management and utilization management, while effectively coordinating care and communication with providers. Holds an active clinical license and possesses extensive experience in mental health and substance use disorders.

Highest-signal resume keywords

Active Behavioral Health Clinical License3+ Years Behavioral Health ExperienceCrisis Management SkillsUtilization Management ExperienceTelephonic Communication Skills

ATS Keywords

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Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard Skills

Crisis ManagementUtilization ManagementBehavioral Health AssessmentEvidence-Based Guidelines ApplicationRisk AssessmentTelephonic Support CoordinationDocumentation SkillsIntervention CoordinationQuality Care SupportCost-Effective Care Strategies

Soft Skills

Effective CommunicationCollaborationMultitaskingJudgmentEmpathy

Tools & Technologies

Computer-Based Work SystemsTelehealth Platforms

Certifications & Qualifications

LCSWLICSWLISWLMSWLPCLMHCLCMHCLMFTClinical Psychologist LicenseRegistered Nurse License

Industry Keywords

Behavioral HealthMental HealthSubstance Use DisordersManaged CarePrior AuthorizationHospital-Based ExperienceQuality CareMember OutcomesCrisis InterventionTelephonic Support

About the role

Key responsibilities & impact

Review preauthorization requests for behavioral health services using evidence-based guidelines and clinical judgment
Coordinate, document, and communicate utilization management decisions with providers and stakeholders
Manage crisis calls, assess risk, determine support needs, and coordinate appropriate interventions
Escalate suicide risk, self-harm concerns, and welfare checks when necessary
Apply clinical expertise to support quality, cost-effective care and positive member outcomes
Work in a fast-paced, queue-based environment while managing multiple priorities
Collaborate with providers and care teams to facilitate appropriate levels of care

Requirements

What you’ll need

Active, unrestricted independent behavioral health clinical license in the state of residence, including LCSW, LICSW, LISW, LMSW, LPC, LMHC, LCMHC, LMFT, Clinical Psychologist, or RN
3+ years of post-licensure behavioral health experience
3+ years of experience working with mental health and substance use disorders
Ability to effectively manage telephonic and computer-based work simultaneously
High-speed residential internet service with minimum 25 Mbps download and 3 Mbps upload
Must be available for the stated Thursday-Friday and Saturday-Sunday night-shift schedule
Must be available to work holidays
Hospital-based behavioral health experience preferred
Utilization Management or Prior Authorization experience preferred
Managed Care experience preferred
Behavioral Health Clinicians: Master’s degree in Social Work, Counseling, or Psychology
Registered Nurses: Bachelor’s degree in Nursing with an emphasis in Behavioral Health or Psychology

Benefits

Comp & perks

10% shift differential
Fully remote position available anywhere in the U.S.
Opportunity to apply clinical expertise in a non-traditional setting
Meaningful work that improves access to quality behavioral health care
Collaborative, mission-driven team environment
Medical coverage
Dental coverage
Vision coverage
Paid time off
Retirement savings options
Wellness programs
Other resources supporting physical, emotional, and financial well-being of colleagues and their families
CVS Health bonus, commission or short-term incentive program in addition to base pay range