Remote LBA/BCBA Utilization Management Consultant

Pennsylvania Psychological Association; United States; Remote; USD 40,000 - 85,000; Full time

Job summary

CVS Health is seeking a licensed Behavior Analyst (LBA) and Board Certified Behavior Analyst (BCBA) for a 100% remote Utilization Management consultant role. The position supports Florida residents, with standard Monday–Friday 8:00 AM–5:00 PM EST hours.

The candidate will review treatment plans, apply evidence-based guidelines, and coordinate with providers to ensure appropriate, evidence-based care while optimizing resource use.

Qualifications

• Must reside in Florida.
• Active LBA license in Florida.
• BCBA certification.
• 3+ years of clinical experience in behavior analysis.
• 2+ years of Microsoft Office experience (Teams/Outlook/Word/Excel).
• 1+ year of EMR experience.

Responsibilities

• Review treatment plans, clinical 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 the continuum of care to support appropriate treatment and utilization of resources.
• Collaborate with providers, care teams, and internal stakeholders to facilitate optimal care and outcomes.
• Identify members who may benefit from additional programs or care coordination resources.
• Support quality improvement by identifying opportunities to enhance treatment effectiveness.
• Serve as a subject matter expert on behavioral analysis within utilization management.

Skills

LBA Florida

BCBA

Clinical experience

Microsoft Office

EMR experience

Education

Master's Degree in Behavior Analysis

Master's Degree in Psychology

Master's Degree in Education

Tools

Microsoft Teams

Outlook

Word

Excel

Job description

CVS Health is seeking a licensed Behavior Analyst (LBA) and Board Certified Behavior Analyst (BCBA) for a 100% remote Utilization Management consultant role. The position supports Florida residents, with standard Monday–Friday 8:00 AM–5:00 PM EST hours.

The candidate will review treatment plans, apply evidence-based guidelines, and coordinate with providers to ensure appropriate, evidence-based care while optimizing resource use.