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From Home Utilization Management Bcba Jobs (NOW HIRING)

O.) from an accredited university Experience * One (1) year of experience in utilization management is required. * Excellent communication and organizational skills required. * Experience in ...

We are currently seeking an Utilization Management Coordinator position for Riveredge Hospital ... Thoroughly understands the management of UM data obtained from admission, concurrent reviews and ...

The Nurse Utilization Management Reviewer has a key role in ensuring the client meets CMS ... May require weekends This is a fully remote work at home role. You must have a secure, private wok ...

The Nurse Utilization Management Reviewer has a key role in ensuring the client meets CMS ... May require weekends This is a fully remote work at home role. You must have a secure, private wok ...

The Nurse Utilization Management Reviewer has a key role in ensuring the client meets CMS ... May require weekends This is a fully remote work at home role. You must have a secure, private wok ...

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From Home Utilization Management Bcba information

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$47.5K

$89.1K

$149K

How much do from home utilization management bcba jobs pay per year?

As of Jul 24, 2026, the average yearly pay for from home utilization management bcba in the United States is $89,075.00, according to ZipRecruiter salary data. Most workers in this role earn between $74,000.00 and $90,500.00 per year, depending on experience, location, and employer.

What is the difference between From Home Utilization Management Bcba vs From Home Behavior Analyst?

AspectFrom Home Utilization Management BcbaFrom Home Behavior Analyst
CertificationsBCBA or BCaBA, plus utilization management trainingBCBA or BCaBA, with behavior analysis certification
Work EnvironmentUtilization review, insurance companies, healthcare settingsBehavior therapy, client homes, clinics, schools
Employer & Industry UsageHealth insurance providers, managed care organizationsBehavior analysis agencies, educational institutions

From Home Utilization Management Bcba focuses on reviewing and approving treatment plans within healthcare and insurance settings, often involving utilization review. In contrast, From Home Behavior Analyst primarily provides direct behavioral therapy and assessments to clients, often in home or clinical environments. Both roles require BCBA certification but differ in daily tasks and work settings.

What cities are hiring for From Home Utilization Management Bcba jobs? Cities with the most From Home Utilization Management Bcba job openings:
What are the most commonly searched types of Utilization Management Bcba jobs? The most popular types of Utilization Management Bcba jobs are:
What states have the most From Home Utilization Management Bcba jobs? States with the most job openings for From Home Utilization Management Bcba jobs include:
Utilization Management Clinical

$50 - $60/hr

Full-time

Posted 7 days ago


Job description

The Utilization Manager, Registered Nurse, is an office-based nursing position responsible for supporting high-quality patient care through clinical oversight, utilization management, and real-time guidance to field clinicians. This role serves as a key clinical resource within the organization, assisting with nursing calls, care coordination, and clinical decision-making to promote positive patient outcomes while ensuring regulatory and payer compliance.

Key responsibilities include:

  • Provide clinical support and guidance to field clinicians, including RNs, LVNs, and therapy staff.

  • Take and triage nursing calls from clinicians, patients, and caregivers as appropriate.

  • Collaborate with field staff to assist with clinical problem-solving, patient status changes, and care planning.

  • Review plans of care and clinical documentation to ensure appropriate utilization of services and skilled need.

  • Monitor visit frequencies and service utilization in alignment with physician orders, payer guidelines, and agency standards.

  • Support case managers with recertifications, discharges, transitions of care, and care coordination.

  • Participate in interdisciplinary collaboration to promote continuity of care and effective communication.

  • Identify clinical risks or concerns and escalate issues appropriately.

  • Support compliance with Medicare Conditions of Participation, regulatory requirements, and agency policies.

  • Contribute to quality improvement initiatives focused on patient outcomes, documentation accuracy, and clinical best practices.

Required Qualifications

  • Active Registered Nurse (RN) license in the state of California.

  • Strong clinical assessment, critical-thinking, and decision-making skills.

  • Excellent verbal and written communication skills.

  • Ability to work collaboratively with interdisciplinary teams.

  • Proficiency with electronic medical records (EMR) systems and basic computer applications.

Preferred Qualifications

  • Experience in utilization management, case management, or clinical coordination.

  • Home Health experience preferred but not required.

  • Knowledge of Medicare home health regulations, payer guidelines, and Conditions of Participation.

  • Experience providing clinical support, education, or mentorship to field clinicians.

  • Strong organizational skills with the ability to manage multiple priorities in a fast-paced office environment.