Behavioral Analysis Utilization Management Clinical Consultant

CVS Health

. Review treatment plans, clinical documentation, and service requests for behavioral analysis and autism-related services .

Posted 10/8/2026full-timeRemote • Florida • United StatesMid-LevelSenior💰 $29 - $62 per hourWebsite

Core Competencies

Role fit

Core Competencies

Use this summary to align your resume positioning with the role.

Demonstrates expertise in behavioral analysis and autism treatment, with a focus on clinical evaluation, utilization management, and quality improvement. Proficient in collaborating with care teams and stakeholders to enhance treatment outcomes and resource utilization.

Highest-signal resume keywords

Licensed Behavior Analyst (LBA)Board Certified Behavior Analyst (BCBA)Clinical Experience in Behavior AnalysisUtilization Management ExperienceMicrosoft Office Applications

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Behavior AnalysisAutism TreatmentClinical Documentation ReviewEvidence-Based Clinical GuidelinesUtilization ReviewClaims ReviewElectronic Medical Records (EMR)Quality ImprovementTreatment Plan EvaluationCare Coordination

Soft Skills

Strong Organizational SkillsAbility to Prioritize TasksCollaborationCommunication

Tools & Technologies

Microsoft TeamsMicrosoft OutlookMicrosoft WordMicrosoft Excel

Certifications & Qualifications

Licensed Behavior Analyst (LBA)Board Certified Behavior Analyst (BCBA)

Industry Keywords

Florida Medicaid Healthcare SystemManaged CareBehavioral HealthClinical ExperienceFast-Paced Environment

About the role

Key responsibilities & impact

Review treatment plans, clinical documentation, and service requests for behavioral analysis and autism-related services
Apply evidence-based clinical guidelines, policies, and professional judgment to determine medical necessity and coverage recommendations
Evaluate and monitor services across the continuum of care to support appropriate treatment and benefit utilization
Collaborate with providers, care teams, and internal stakeholders to facilitate optimal care and treatment outcomes
Identify members who may benefit from additional programs, services, or care coordination resources
Support quality improvement efforts by identifying opportunities to enhance treatment effectiveness and resource utilization
Serve as a subject matter expert on behavioral analysis services within the utilization management process

Requirements

What you’ll need

Must reside in Florida
Active, unrestricted Licensed Behavior Analyst (LBA) license in Florida
Active, unrestricted Board Certified Behavior Analyst (BCBA) certification
3+ years of clinical experience in behavior analysis, autism treatment, behavioral health, or a related setting
2+ years of experience using Microsoft Office applications (Teams, Outlook, Word, Excel)
1+ year of experience using electronic medical records (EMR) systems
Ability to work Monday–Friday, 8:00 AM–5:00 PM EST
Strong organizational skills with the ability to prioritize multiple tasks in a fast-paced environment
Ability to participate in rotating evening and weekend on-call coverage as required by state regulatory requirements
Experience working within the Florida Medicaid healthcare system (preferred)
Managed Care experience (preferred)
Utilization Review or Utilization Management experience (preferred)
Claims review experience (preferred)
Master's Degree in Behavior Analysis, Psychology, Education, or a related field

Benefits

Comp & perks

CVS Health bonus, commission or short-term incentive program in addition to base pay
Medical coverage
Dental coverage
Vision coverage
Paid time off
Retirement savings options
Wellness programs
Other resources supporting physical, emotional, and financial well-being