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Cvs Health Utilization Management Remote Jobs in Minnesota

CVS Health

Senior Project Manager Meritain TPA

Plymouth, MN · On-site +1

$67K - $199K/yr

At CVS Health, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose ... Position may sit anywhere in the US and may be either remote or hybrid depending on candidate ...

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What is the difference between Cvs Health Utilization Management Remote vs Cvs Health Medical Reviewer?

AspectCvs Health Utilization Management RemoteCvs Health Medical Reviewer
CredentialsRN, LPN, or other healthcare licensesRN, MD, or DO licenses
Work EnvironmentRemote, home-basedRemote or onsite, depending on role
Employer & Industry UsageUtilization management for insurance approvalsMedical review for claims and authorizations

Both roles involve healthcare assessments, often requiring similar licenses. Utilization Management Remote focuses on reviewing medical necessity for insurance purposes, while Medical Reviewers may handle detailed case evaluations. Both are remote-friendly and integral to healthcare insurance processes, but differ slightly in scope and responsibilities.

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Cvs Health Utilization Management Remote jobs near you
Infographic showing various Cvs Health Utilization Management Remote job openings in Minnesota as of August 2026, with employment types broken down into 100% Full Time. Highlights an 100% Remote job distribution.

Behavioral Health Utilization Management Clinician

Adecco

Minneapolis, MN • Remote

$39 - $41.40/hr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted yesterday

New

Job description

Adecco Healthcare & Life Sciences is currently hiring a Behavioral Health Utilization Management Clinician for a remote telecommute opportunity in Nevada.

This is a remote opportunity with a Monday–Friday schedule.

Please review the details below and apply with an updated resume for consideration.

Position Details:

· Pay: $39 to $41.40/hour

· Contract: Four to Six-Contract, possibility of extension or becoming permanent

· Location: Remote / Telecommute

· Schedule: Monday–Friday, 8:00 AM–5:00 PM PST

Primary Responsibilities:

· Review outpatient ABA requests for medical necessity using established clinical criteria, including MCG, InterQual, ASAM, and plan-specific guidelines.

· Evaluate treatment plans, progress reports, assessments, and supporting documentation submitted by providers.

· Collaborate with providers to clarify documentation and ensure the appropriate level of care.

· Make determinations or recommendations for approval, modification, or denial of services.

· Document clinical decisions and rationale accurately in the utilization management system.

· Review clinical information and apply established guidelines to support appropriate behavioral health services.

· Manage multiple cases in a high-volume, deadline-driven environment.

· Collaborate with internal clinical and administrative teams to support quality patient care.

Qualifications:

· BCBA, LBA, RN, Master's degree in Social Work, or related behavioral health field.

· LCSW, LPC, LMFT, or equivalent behavioral health credentials accepted.

· Active, unrestricted behavioral health license in the State of Nevada preferred.

· Minimum of 2 years of behavioral health clinical experience, including ABA experience.

· Familiarity with Medicaid and commercial benefit structures and utilization management protocols.

· Experience reviewing clinical documentation and determining medical necessity.

· Ability to work independently and effectively within a remote team environment.

· Proficiency with clinical systems, Microsoft Office applications, and electronic documentation platforms.

· Strong ability to multitask and meet deadlines in a high-volume environment.

· Experience in behavioral health utilization management or prior authorization.

Why Work for Adecco?

· Excellent Weekly Pay

· 401(k) Plan

· Skills Training

· Medical, Dental, and Vision Benefits


Pay Details: $39.00 to $41.40 per hour
Benefit offerings available for our associates include medical, dental, vision, life insurance, short-term disability, additional voluntary benefits, EAP program, commuter benefits and a 401K plan. Our benefit offerings provide employees the flexibility to choose the type of coverage that meets their individual needs. In addition, our associates may be eligible for paid leave including Paid Sick Leave or any other paid leave required by Federal, State, or local law, as well as Holiday pay where applicable.
Equal Opportunity Employer/Veterans/Disabled
Military connected talent encouraged to apply
To read our Candidate Privacy Information Statement, which explains how we will use your information, please navigate to https://www.adecco.com/en-us/candidate-privacy
The Company will consider qualified applicants with arrest and conviction records in accordance with federal, state, and local laws and/or security clearance requirements, including, as applicable:
  • The California Fair Chance Act
  • Los Angeles City Fair Chance Ordinance
  • Los Angeles County Fair Chance Ordinance for Employers
  • San Francisco Fair Chance Ordinance

Massachusetts Candidates Only: It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability.