Remote LBA/BCBA Utilization Management Clinician

CVS Health Corporation; Miami, Fort Lauderdale (FL, FL); Remote; USD 40,000 - 85,000; Full time

Benefits offered by this job

Medical, dental, vision

Paid time off

Retirement savings

Wellness programs

Job summary

CVS Health Corporation invites Florida-licensed LBA/BCBA professionals to join a 100% remote Utilization Management team. This Clinical Consultant role focuses on evidence-based behavioral analysis and autism services, ensuring medical necessity and optimal resource use, while collaborating with providers and internal stakeholders.

Qualified candidates bring 3+ years of related clinical experience, Florida licensure, BCBA certification, and proficiency with Office apps and EMR systems.

Qualifications

• Florida-licensed LBA (Florida)
• Active, unrestricted BCBA certification
• 3+ years of clinical experience in behavior analysis/autism/behavioral health
• 2+ years using Microsoft Office (Teams/Outlook/Word/Excel)
• 1+ year using EMR systems
• Ability to work Monday–Friday, 8:00 AM–5:00 PM EST
• Strong organizational skills; multitask in fast-paced setting
• Willingness to participate in rotating on-call coverage as required

Responsibilities

• Review treatment plans, clinical documentation, and service requests.
• Apply evidence-based guidelines and professional judgment to determine medical necessity.
• Evaluate and monitor services across care continuum for appropriate treatment.
• Collaborate with providers and care teams to improve outcomes.
• Identify members who may benefit from additional programs or care coordination.
• Support quality improvement by identifying opportunities to enhance effectiveness.
• Serve as subject matter expert on behavioral analysis within utilization management

Skills

Clinical experience

Microsoft Office

EMR systems

Regulatory compliance

Education

Master's Degree in Behavior Analysis

Tools

Microsoft Office Suite

EMR systems

Job description

CVS Health Corporation invites Florida-licensed LBA/BCBA professionals to join a 100% remote Utilization Management team. This Clinical Consultant role focuses on evidence-based behavioral analysis and autism services, ensuring medical necessity and optimal resource use, while collaborating with providers and internal stakeholders.

Qualified candidates bring 3+ years of related clinical experience, Florida licensure, BCBA certification, and proficiency with Office apps and EMR systems.