Remote Behavior Analysis & Utilization Consultant (FL)

CVS Health; Lorida (FL); Remote; USD 40,000 - 86,000; Full time

Benefits offered by this job

Medical coverage

Dental coverage

Vision coverage

Paid time off

Retirement savings

Job summary

CVS Health is seeking a Behavior Analysis Utilization Management Clinical Consultant (LBA/BCBA) for a fully remote role serving Florida residents. The position requires 3+ years of clinical experience in behavior analysis or related fields, with comfort using Microsoft Office tools and EMR systems.

Candidate will review treatment plans and apply guidelines to determine medical necessity within utilization management.

Qualifications

• 3+ years of clinical experience in behavior analysis, autism treatment, behavioral health, or a related setting.
• Experience with utilization management processes and medical necessity determinations.
• Familiarity with Florida Medicaid guidelines is a plus.

Responsibilities

• Review treatment plans, clinical documentation, and service requests for behavioral analysis and autism-related services.
• Apply evidence-based clinical guidelines 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 within the utilization management process.
• Collaborate with providers and multidisciplinary healthcare teams.
• Contribute to improving member outcomes and family experiences with autism and behavioral health treatment.

Skills

Clinical experience

Behavior analysis

Autism treatment

Behavioral health

Utilization management

Microsoft Office

Tools

Microsoft Office

Job description

CVS Health is seeking a Behavior Analysis Utilization Management Clinical Consultant (LBA/BCBA) for a fully remote role serving Florida residents. The position requires 3+ years of clinical experience in behavior analysis or related fields, with comfort using Microsoft Office tools and EMR systems.

Candidate will review treatment plans and apply guidelines to determine medical necessity within utilization management.