Remote LBA/BCBA Utilization Management Consultant

Miami Neuroscience Institute Baptist Health South Florida; United States; Remote; USD 83,383,000 - 178,573,000; Full time

Job summary

CVS Health is hiring a Behavior Analysis Utilization Management Clinician (LBA/BCBA) for a fully remote role focused on ABA and behavioral health services. Florida residency is required, with standard hours Monday–Friday 8:00 AM–5:00 PM EST.

The role emphasizes medical necessity, treatment optimization, and collaboration with care teams. The candidate will review treatment plans, apply guidelines, and monitor services while supporting quality outcomes and efficient resource use.

Qualifications

• Active, unrestricted LBA license in Florida.
• Active, unrestricted BCBA certification.
• 3+ years of clinical experience in behavior analysis or related field.
• 2+ years of MS Office experience (Teams, Outlook, Word, Excel).
• 1+ year of EMR experience.
• Florida residency required.

Responsibilities

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

Skills

LBA license

BCBA certification

MS Office proficiency

EMR systems experience

Education

Florida LBA license

BCBA certification

Master's degree in Behavior Analysis or related field

Tools

Microsoft Office (Teams/Outlook/Word/Excel)

EMR systems

Job description

CVS Health is hiring a Behavior Analysis Utilization Management Clinician (LBA/BCBA) for a fully remote role focused on ABA and behavioral health services. Florida residency is required, with standard hours Monday–Friday 8:00 AM–5:00 PM EST.

The role emphasizes medical necessity, treatment optimization, and collaboration with care teams. The candidate will review treatment plans, apply guidelines, and monitor services while supporting quality outcomes and efficient resource use.