Remote LBA/BCBA Utilization Consultant — Behavioral Health

Istss; United States; Remote; USD 4,009,000 - 8,585,000; Full time

Benefits offered by this job

Bonus eligibility

Job summary

CVS Health is seeking a Licensed Behavior Analyst (LBA) and Board Certified Behavior Analyst (BCBA) for a 100% remote Utilization Management Clinical Consultant role, primarily serving Florida residents. The position emphasizes evidence-based behavior analysis, medical necessity reviews, and collaboration with care teams to optimize outcomes.

Ideal candidates will have 3+ years of clinical experience in behavior analysis and autism treatment, Florida licensure, and proficiency with EMR systems

Qualifications

• 3+ years of clinical experience in behavior analysis, autism treatment, behavioral health, or related setting.
• 2+ years of experience using Microsoft Office applications (Teams, Outlook, Word, Excel).
• Master's degree in Behavior Analysis, Psychology, Education, or related field.

Responsibilities

• 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.
• Collaborate with providers, care teams, and internal stakeholders to facilitate optimal care and treatment outcomes.
• Identify members who may benefit from additional programs, services, or care coordination resources.
• 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.

Skills

Microsoft Office

Organizational skills

Communication

Education

Master's Degree in Behavior Analysis / Psychology / Education

Tools

EMR systems

Microsoft Office Suite

Job description

CVS Health is seeking a Licensed Behavior Analyst (LBA) and Board Certified Behavior Analyst (BCBA) for a 100% remote Utilization Management Clinical Consultant role, primarily serving Florida residents. The position emphasizes evidence-based behavior analysis, medical necessity reviews, and collaboration with care teams to optimize outcomes.

Ideal candidates will have 3+ years of clinical experience in behavior analysis and autism treatment, Florida licensure, and proficiency with EMR systems