Utilization Management Clinical Consultant – Sunday, Thursday

This is a fully remote position, open to applicants in Alabama, +46 more states.

📋 Description

• Evaluate behavioral health services and treatment plans to assess medical necessity and appropriateness of care.

• Implement evidence-based guidelines and clinical best practices across various levels of care.

• Coordinate and communicate utilization management decisions with healthcare providers and care teams.

• Provide triage support and crisis intervention as required.

• Facilitate efficient discharge planning and transitions of care.

• Identify members at risk for adverse outcomes and coordinate referrals to additional programs and services.

• Advocate for quality, cost-effective healthcare utilization and positive outcomes for members.

• Collaborate with both internal and external stakeholders to enhance comprehensive care management.

⛳️ Requirements

• Active, unrestricted independent Behavioral Health license in Louisiana (LCSW, LCPC, LMFT, LPCC, LPAT, LPC), or an active, unrestricted Compact RN license with psychiatric specialty experience.

• A minimum of 3 years of clinical practice experience in behavioral health.

• At least 1 year of experience with Electronic Medical Record (EMR) documentation.

• Availability to work Sunday–Thursday, 8:00 AM–5:00 PM Central Standard Time, with flexibility for occasional weekends and holidays.

• A Master's degree is required for independently licensed Behavioral Health clinicians.

• Registered Nurse with psychiatric specialty experience and an unrestricted nursing license will also be considered (Bachelor’s Degree in Nursing).

• Residency in Louisiana is strongly preferred.

• Previous experience in Managed Care, Utilization Review, or Utilization Management is preferred.

• Previous inpatient behavioral health experience is preferred.

• Licensed Addiction Counselor (LAC) certification is preferred.

• Strong multitasking, prioritization, and organizational abilities.

• Proficient in navigating multiple systems and applications in a fast-paced environment.

🏝️ Benefits

• CVS Health bonus, commission, or short-term incentive program in addition to the base salary range.

• Medical insurance coverage.

• Dental insurance coverage.

• Vision insurance coverage.

• Paid time off benefits.

• Retirement savings options available.

• Wellness programs offered.

• Additional resources supporting physical, emotional, and financial well-being.

• Remote work flexibility within a supportive team culture.