Behavioral Analysis Utilization Management Clinical Consultant-FLORIDA

CVS Health; Florida; Remote; USD 40.000 - 85.000; Vollzeit

Benefits dieser Stelle

Remote opportunity within Florida

Bonus eligibility (CVS Health bonus/in

Comprehensive benefits package

Zusammenfassung

CVS Health is hiring a Behavior Analysis Utilization Management Clinical Consultant (LBA/BCBA) for a 100% remote role serving Florida residents. The position requires FL licensure and involves reviewing treatment plans, determining medical necessity, and supporting utilization management processes.

The role emphasizes evidence-based care, quality outcomes, and collaboration with providers. Ideal candidates have 3+ years in behavior analysis or autism treatment, 2+ years of MS Office experience,

Qualifikationen

• Florida-licensed LBA/BCBA required
• Experience in ABA/behavioral health settings
• Experience with Medicaid/managed care
• Utilization management experience a plus

Aufgaben

• Review treatment plans, documentation, and service requests for behavioral analysis and autism-related services
• Apply evidence-based guidelines to determine medical necessity and coverage
• Evaluate and monitor services to support appropriate treatment and benefit utilization
• Support quality improvement by identifying opportunities to enhance treatment effectiveness
• Serve as a subject matter expert on behavioral analysis within utilization management

Kenntnisse

Clinical experience in behavior分析

Microsoft Office experience

EMR experience

Ability to work standard hours

On-call coverage availability

Ausbildung

LBA/BCBA license

Tools

EMR systems

Microsoft Office (Teams, Outlook, Word, Excel)

Jobbeschreibung

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.

Behavior Analysis Utilization Management Clinical Consultant (LBA/BCBA)

100% Remote | Florida Residents Only | Monday-Friday, 8:00 AM-5:00 PM EST

Are you a Licensed Behavior Analyst and Board Certified Behavior Analyst passionate about improving outcomes for individuals receiving ABA and behavioral health services? Join our Utilization Management team and use your clinical expertise to ensure members receive appropriate, evidence-based care while supporting quality outcomes and effective resource utilization.

• Review treatment plans, clinical documentation, and service requests for behavioral analysis and autism-related services
• Apply evidence-based clinical guidelines, policies, and professional judgment to determine medical necessity and coverage recommendations
• Evaluate and monitor services across the continuum of care to support appropriate treatment and benefit utilization
• Support quality improvement efforts by identifying opportunities to enhance treatment effectiveness and resource utilization
• Serve as a subject matter expert on behavioral analysis services within the utilization management process

• 3+ years of clinical experience in behavior analysis, autism treatment, behavioral health, or a related setting
• ~2+ years of experience using Microsoft Office applications (Teams, Outlook, Word, Excel)
• ~1+ year of experience using electronic medical records (EMR) systems
• ~ Ability to work Monday-Friday, 8:00 AM-5:00 PM EST
• ~ Ability to participate in rotating evening and weekend on-call coverage as required by state regulatory requirements

• Experience working within the Florida Medicaid healthcare system
• Managed Care experience
• Utilization Review or Utilization Management experience
• Claims review experience
• Behavior Analysis
• Psychology
• Or a related field

• Fully remote opportunity within Florida
• Apply your ABA and behavioral health expertise in a specialized Utilization Management role
• Influence quality, access, and effectiveness of behavioral health services
• Collaborate with providers and multidisciplinary healthcare teams
• Make a meaningful impact on members and families receiving autism and behavioral health treatment

If you're a Florida-licensed LBA/BCBA with a passion for evidence-based care, utilization management, and improving member outcomes, we'd love to hear from you.

Full time Pay Range

The typical pay range for this role is: $29.10 - $62.32 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. 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 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.

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: 10/24/2026 Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.