Remote LBA/BCBA Utilization Management Clinician

MePA; Northern (KY); Hybride; USD 3 995 000 - 8 541 000; Plein temps

Résumé du poste

CVS Health is seeking a Licensed Behavior Analyst (LBA) and Board Certified Behavior Analyst (BCBA) for a fully remote Utilization Management role in Florida. The position requires 3+ years in behavior analysis, BCBA/ LBA credentials, and strong organizational and EMR skills, with typical hours 8:00 AM-5:00 PM EST, Monday through Friday.

You will review treatment plans, apply guidelines, and collaborate with care teams to ensure evidence-based, efficient, and appropriate services across the

Qualifications

• Must reside in Florida.
• Active, unrestricted LBA license in Florida.
• Active, unrestricted BCBA certification.
• 3+ years of clinical experience in behavior analysis/ autism/ behavioral health.
• 2+ years of Microsoft Office experience (Teams/Outlook/Word/Excel).
• 1+ year of EMR experience.
• Ability to work Monday-Friday, 8:00 AM-5:00 PM EST.
• Strong organizational skills and ability to manage multiple tasks.

Responsabilités

• Review treatment plans, clinical docs, and service requests for behavioral analysis and autism-related services.
• Apply evidence-based guidelines to determine medical necessity and coverage.
• Monitor services across care continuum to support appropriate treatment and utilization.
• Collaborate with providers and internal teams to facilitate optimal care outcomes.
• Identify members who may benefit from additional programs or care coordination.
• Support quality improvement efforts to enhance treatment effectiveness and resource use.
• Serve as subject matter expert on behavioral analysis within utilization management.

Connaissances

Clinical experience

Organizational skills

Microsoft Office

On-call readiness

Formation

Master's Degree in Behavior Analysis/Psychology/Education

Outils

EMR systems

Description du poste

CVS Health is seeking a Licensed Behavior Analyst (LBA) and Board Certified Behavior Analyst (BCBA) for a fully remote Utilization Management role in Florida. The position requires 3+ years in behavior analysis, BCBA/ LBA credentials, and strong organizational and EMR skills, with typical hours 8:00 AM-5:00 PM EST, Monday through Friday.

You will review treatment plans, apply guidelines, and collaborate with care teams to ensure evidence-based, efficient, and appropriate services across the