Hiring: Utilization Management Clinical Consultant (Monday - Friday) Company: CVS Health Location: Baton Rouge, LA Job Posted Time: 2026-09-10 10:59:55 Employment Type: Full-time / Remote Target Skills & Keywords : EMR, Utilization Review About the job Experience: •Strong multitasking, prioritization, and organizational skills •Proficiency navigating multiple systems and applications in a fast-paced environment Required Skills: •Review behavioral health services and treatment plans to determine medical necessity and appropriateness of care •Coordinate and communicate utilization management decisions with providers and care teams •Provide triage support and crisis intervention as needed •Facilitate effective discharge planning and transitions of care •Identify members at risk for poor outcomes and coordinate referrals to additional programs and services •Promote quality, cost-effective healthcare utilization and positive member outcomes •Partner cross-functionally with internal and external stakeholders to support comprehensive care management •Active, unrestricted independent Behavioral Health license in Louisiana (LCSW, LCPC, LMFT, LPCC, LPAT, LPC) or Active, unrestricted Compact RN license with psychiatric specialty experience Qualifications: •Managed Care, Utilization Review, or Utilization Management experience •Master's degree required for independently licensed Behavioral Health clinicians •Registered Nurse with psychiatric specialty experience and unrestricted nursing license also considered (Bachelor’s Degree in Nursing) •Licensed Addiction Counselor (LAC) certification Compensation: •Flexible work environment (work from home / hybrid options) •Competitive benefits and rewards package •This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above Interested candidates, please apply directly through the job posting on company's career page or try via AI auto apply on this platform. Don't miss this opportunity to join a forward-thinking team!