Remote LBA/BCBA Utilization Management Consultant (Florida)

CVS Health Corporation; Tallahassee (FL); Remote; USD 40,000 - 86,000; Full time

Job summary

CVS Health Corporation seeks a licensed Behavior Analyst (LBA) and BCBA to join the Utilization Management team in a fully remote, Florida-resident capacity. You will evaluate treatment plans, apply clinical guidelines, and support evidence-based care while promoting efficient resource use.

The role requires 3+ years of clinical experience in ABA or related fields, Florida licensure, and strong EMR/Office software skills, with on-call rotations as needed.

Qualifications

• Florida resident with active LBA license and BCBA certification.
• 3+ years of clinical experience in behavior analysis or related field.
• 2+ years using Microsoft Office (Teams/Outlook/Word/Excel).
• 1+ year of experience with EMR systems.
• Availability for Mon-Fri 8:00 AM–5:00 PM EST and on-call as required.

Responsibilities

• Review treatment plans and service requests for ABA and autism services.
• Apply guidelines to determine medical necessity and coverage decisions.
• Monitor services across care continuum to support appropriate treatment.
• Collaborate with providers and internal teams to ensure optimal outcomes.
• Identify members who may benefit from additional programs or care coordination.
• Support quality improvement and utilization management efforts.
• Serve as SME for behavioral analysis within utilization management.

Skills

LBA license

BCBA certification

Clinical experience

Microsoft Office

EMR systems

On-call readiness

Education

Master's Degree in Behavior Analysis / Psychology

Tools

Microsoft Office

EMR systems

Job description

CVS Health Corporation seeks a licensed Behavior Analyst (LBA) and BCBA to join the Utilization Management team in a fully remote, Florida-resident capacity. You will evaluate treatment plans, apply clinical guidelines, and support evidence-based care while promoting efficient resource use.

The role requires 3+ years of clinical experience in ABA or related fields, Florida licensure, and strong EMR/Office software skills, with on-call rotations as needed.