Remote LBA/BCBA Utilization Management Consultant (FL)

CVS Health Corporation; United States; Remote; USD 4,009,000 - 8,585,000; Full time

Job summary

CVS Health Corporation is seeking a Behavior Analysis Utilization Management Clinical Consultant (LBA/BCBA) to support medical necessity reviews and evidence-based care.

This 100% remote role is for Florida residents, Monday–Friday 8:00 AM–5:00 PM EST, coordinating with care teams and providers to optimize treatment outcomes and resource use.

Requires Florida LBA and BCBA licenses, 3+ years clinical experience, and proficiency with EMR and Microsoft Office.

Qualifications

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

Responsibilities

• Review treatment plans, clinical docs, and service requests for behavioral analysis and autism services.
• Apply guidelines and policies to determine medical necessity and coverage.
• Monitor services to support appropriate treatment and utilization.
• Collaborate with providers and care teams to optimize outcomes.
• Identify members who may need additional programs or coordination.
• Support quality improvement in treatment effectiveness and resource use.
• Serve as SME on behavioral analysis within utilization management.

Skills

Clinical experience

Team collaboration

Education

Master's Degree in Behavior Analysis

Master's Degree in Psychology

Master's Degree in Education

Tools

Microsoft Office

EMR systems

Job description

CVS Health Corporation is seeking a Behavior Analysis Utilization Management Clinical Consultant (LBA/BCBA) to support medical necessity reviews and evidence-based care.

This 100% remote role is for Florida residents, Monday–Friday 8:00 AM–5:00 PM EST, coordinating with care teams and providers to optimize treatment outcomes and resource use.

Requires Florida LBA and BCBA licenses, 3+ years clinical experience, and proficiency with EMR and Microsoft Office.