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Utilization Management Clinician Behavioral Health

Work from home Full-time role Hiring

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, EST Hours) Schedule: Monday–Friday, 11:30 AM – 8:00 PM EST

About the Role

Join a collaborative team where your clinical expertise directly impacts member outcomes. As a Behavioral Health Utilization Management Clinician, you’ll use your clinical judgment and evidence-based practices to ensure members receive appropriate, high-quality care across levels of treatment. This is a fast-paced, queue-based role ideal for clinicians who enjoy critical thinking, care coordination, and making a meaningful difference. What You’ll Do Review and evaluate treatment plans using evidence-based guidelines Coordinate care and facilitate access to appropriate behavioral health services Conduct triage and provide crisis support as needed Collaborate with providers to optimize treatment outcomes Identify at-risk members and connect them with additional resources and programs Apply clinical criteria, policy, and professional judgment to make coverage recommendations What You Bring - REQUIRED Active, unrestricted independent clinical license (LPC, LCSW, LMFT, LMHC, or RN with 5 years of behavioral health experience) 3+ years of behavioral health experience Strong knowledge of mental health and substance use disorders Ability to multitask (talk on phone and document simultaneously) in a queue-based environment Availability to work EST hours listed above

Nice to Have

Post-master’s direct clinical experience (hospital, outpatient, or ambulatory settings) Managed care or utilization review experience Crisis intervention experience Education Master’s degree (for clinical licensure) or BSN for RNs preferred Why Join Us? Be part of a mission-driven team focused on improving behavioral health outcomes through thoughtful, evidence-based care coordination—while working in a structured, supportive environment. Anticipated Weekly Hours 40 Time Type Full time Pay Range The typical pay range for this role is: $60,522.00 - $142,576.00 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: 06/13/2026 Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

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