CVS Health
Behavioral Analysis Utilization Management Clinical Consultant-FLORIDA
FL - Work from home · Remote · Full-time · Posted Oct 27, 2026
- Experience
- 3+ years of relevant clinical experience; 2+ years using Microsoft Office applications; 1+ year using EMR systems.
- Education
- Master's Degree in Behavior Analysis, Psychology, Education, or a related field.
About the job
Reviews behavioral analysis and autism-related treatment requests to make medical-necessity and coverage recommendations and support appropriate care and resource utilization.
What you'll do
- Review treatment plans, clinical documentation, and service requests using evidence-based guidelines and professional judgment.
- Monitor services, collaborate with providers and care teams, and identify members who may benefit from additional programs or care coordination.
- Contribute to quality improvement and serve as a behavioral analysis subject matter expert in utilization management.
What they ask for
- Florida resident with an active, unrestricted Florida BCBA certification and an active, unrestricted LBA license or equivalent relevant licensure.
- 3+ years of clinical experience in behavior analysis, autism treatment, behavioral health, or a related setting.
- 2+ years using Microsoft Office applications and 1+ year using electronic medical records (EMR) systems.
- Availability Monday–Friday, 8:00 AM–5:00 PM EST, and for rotating evening and weekend on-call coverage as required.
Nice to have
- Experience within the Florida Medicaid healthcare system, managed care, utilization review or management, or claims review.
Pay
$29.10 - $62.32 USD base hourly rate or base annual full-time salary
Tools
Microsoft Office, Teams, Outlook, Word, Excel, electronic medical records (EMR) systems
Model-written summary · the original posting is authoritative