Manager, Behavioral Health Utilization Management - LA Medicaid - RN or BH

At CVS Health, we’re building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care.

As the nation’s leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues – caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day.

Position Summary

This is a fulltime remote teleworker opportunity in Louisiana. The Manager, Utililzation Management, conducts oversight and management of clinical team processes including the organization and development of high performing teams.

This is a fully remote position. Eligible candidates may live anywhere in the contiguous US; however, Louisiana residence is preferred.

Fundamental Components

• Reinforces clinical philosophy, programs, policies and procedures.
• Communicates strategic plan and specific tactics to meet plan.
• Ensures implementation of tactics to meet strategic direction for cost and quality outcomes.
• Creates direction and communicates a business case for change by focusing on and addressing key priorities to achieve business results.
• Identifies opportunities to implement best practice approaches and introduce innovations to better improve outcomes.
• Will be accountable for meeting the financial, operational and quality objectives of the unit.
• Will be accountable for the day-to-day management of team(s) for appropriate implementation and adherence with established practices, policies and procedures.
• Works closely with other functional area managers to ensure consistency in clinical interventions supporting our plan sponsors.
• Develop, initiate, monitor and communicate performance expectations.
• May act as a single point of contact for the customer and the Account Team which includes participation in customer meetings, implementation and oversight of customer cultural requirements, and support implementation of new customers.
• Participate in the recruitment and hiring process for staff using clearly defined requirements in terms of education, experience, technical and performance skills.
• Assesses developmental needs and collaborates with others to identify and implement action plans that support the development of high performing teams.
• Consistently demonstrates the ability to serve as a model change agent and lead change efforts.
• Accountable for maintaining compliance with policies and procedures and implements them at the employee level.
• Ability to evaluate and interpret data, identify areas of improvement, and focuses on interventions to improve outcomes.

Minimum Qualifications

• Active, unrestricted clinical licensure (RN or Behavioral Health as outlined below).
• 5+ years of clinical practice in behavioral healthcare.
• 2+ years of utilization management experience (managed care setting preferred).
• 2+ years of healthcare leadership experience (managed care setting preferred).
• 2+ years of proficiency with personal computers, keyboard navigation, and MS Office Suite.
• 1+ year of experience with electronic medical records.
• Ability to travel up to 10% for in-state meetings.
• Ability to work core business hours (Mon–Fri, 8 AM–5 PM CT) with occasional weekend flexibility.
• High-speed internet access.

Preferred Qualifications

• Louisiana residency.
• Managed care experience.
• Medicaid experience.
• Strong ability to multitask, prioritize, and adapt to a fast-paced, changing environment.

Education & Licensure

• If Registered Nurse:
  • Master’s degree or equivalent experience required (BSN preferred).
  • Active, unrestricted Louisiana RN license or compact license.

• If Behavioral Health:
  • Master’s degree in a field leading to independent Behavioral Health licensure.
  • Current, unencumbered Lousiana license as one of the following:
    • Licensed Professional Counselor (LPC)
    • Licensed Marriage & Family Therapist (LMFT)
    • Licensed Behavioral Practitioner (LBP)
    • Licensed Clinical Social Worker (LCSW)

Anticipated Weekly Hours

40

Time Type

Full time

Pay Range

The typical pay range for this role is:

$78,331.00 - $168,714.00

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 our comprehensive and competitive mix of pay and benefits – investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:

• Affordable medical plan options, a 401(k) plan (including matching company contributions), and an 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.

For more information, visit https://jobs.cvshealth.com/us/en/benefits

We anticipate the application window for this opening will close on: 01/24/2026

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.