ZipRecruiter

Log In

2

Full Time Bcba Utilization Review Jobs (NOW HIRING)

Oscar Health

Utilization Review Nurse

Tempe, AZ · Remote

$35 - $45.94/hr

We're hiring a Utilization Review Nurse to join our Utilization Review team. About the role: You ... Full-time employees are eligible for benefits including: medical, dental, and vision benefits, 11 ...

Dane Street, LLC

Utilization Review Physician

Perform utilization review for: * Preauthorization requests * Appeals (first and second level ... Remote work from home * Full-time, Monday-Friday * Availability for occasional weekends and holiday ...

Umpqua Health

Utilization Review Specialist

Winston, OR · On-site

$41K - $47K/yr

Utilization Review Specialist HYBRID, must be able to travel to 3031 NE STEPHENS ST ... ROSEBURG, OR 97470 EMPLOYMENT TYPE- Full-Time, Exempt About Umpqua Health At Umpqua Health, we're ...

UHS

Utilization Review Coordinator

Brookline, MA

Responsibilities Utilization Review Coordinator Opportunity - HRI Hospital is seeking a Full-time Utilization Review Coordinator to join our skilled and dedicated team of psychiatric professionals ...

New

UHS

Utilization Review Coordinator

Brookline, MA · On-site

Responsibilities Utilization Review Coordinator Opportunity - HRI Hospital is seeking a Full-time Utilization Review Coordinator to join our skilled and dedicated team of psychiatric professionals ...

New

UHS

Utilization Review Coordinator

Brookline, MA

Responsibilities Utilization Review Coordinator Opportunity - HRI Hospital is seeking a Full-time Utilization Review Coordinator to join our skilled and dedicated team of psychiatric professionals ...

New

next page

Showing results 1-20

All JobsBcba Utilization Review JobsFull Time Bcba Utilization Review Jobs

Full Time Bcba Utilization Review information

See salary details

$47.5K

$89.1K

$149K

How much do full time bcba utilization review jobs pay per year?

As of Jul 13, 2026, the average yearly pay for full time bcba utilization review 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 Full Time Bcba Utilization Review vs Full Time Bcba?

AspectFull Time Bcba Utilization ReviewFull Time Bcba
CertificationsBCBA certification requiredBCBA certification required
Work EnvironmentFocuses on reviewing treatment plans and insurance authorizationsProvides direct behavioral therapy to clients
Employer & Industry UsageUsed by insurance companies, clinics, and healthcare organizations for case reviewEmployed by clinics, schools, and private practices for client services
Job ResponsibilitiesAssessing treatment plans, ensuring compliance, reviewing utilizationImplementing behavior intervention plans, direct client work

While both roles require BCBA certification, the Full Time Bcba Utilization Review primarily involves evaluating treatment plans and insurance utilization, whereas the Full Time Bcba provides direct behavioral therapy to clients. The roles differ mainly in daily responsibilities and work focus, though both are essential in behavioral health services.

What is a Full Time BCBA Utilization Review?

A Full Time BCBA Utilization Review is a Board Certified Behavior Analyst who works in a utilization review capacity, typically for insurance companies or healthcare organizations. Their primary role is to review and evaluate treatment plans and service requests for Applied Behavior Analysis (ABA) therapy to ensure medical necessity, effectiveness, and compliance with clinical guidelines. They collaborate with providers, assess documentation, and make recommendations to approve, modify, or deny services based on established criteria. This role requires strong analytical skills, up-to-date knowledge of ABA best practices, and a current BCBA certification. Working full time, these professionals play a key part in maintaining quality standards and cost-effectiveness in behavioral health services.

What are some common challenges faced by a BCBA in Utilization Review positions, and how can they be addressed?

BCBAs working in Utilization Review often navigate the challenge of balancing clinical recommendations with payer requirements and cost-effectiveness. They may encounter situations where they need to justify medically necessary services or adapt treatment plans to align with insurance criteria. Success in this role requires strong communication skills, attention to documentation, and the ability to advocate for clients while maintaining compliance with guidelines. Collaborating closely with clinical teams and staying updated on payer policies can help address these challenges effectively.

What are the key skills and qualifications needed to thrive as a Full Time BCBA Utilization Review specialist, and why are they important?

To thrive as a Full Time BCBA Utilization Review specialist, you need board certification as a Behavior Analyst (BCBA), a solid background in Applied Behavior Analysis (ABA), and experience in clinical case review. Familiarity with electronic health records (EHRs), insurance authorization systems, and documentation software is essential for efficient case management. Strong analytical thinking, written communication, and attention to detail help ensure accurate reviews and clear reports. These skills and qualities are crucial for maintaining compliance, ensuring quality care, and optimizing service delivery in behavioral health settings.
More about Full Time Bcba Utilization Review jobs
What cities are hiring for Full Time Bcba Utilization Review jobs? Cities with the most Full Time Bcba Utilization Review job openings:
What are the most commonly searched types of Bcba Utilization Review jobs? The most popular types of Bcba Utilization Review jobs are:
What states have the most Full Time Bcba Utilization Review jobs? States with the most job openings for Full Time Bcba Utilization Review jobs include:
What job categories do people searching Full Time Bcba Utilization Review jobs look for? The top searched job categories for Full Time Bcba Utilization Review jobs are:
Full Time Bcba Utilization Review jobs near you
Infographic showing various Full Time Bcba Utilization Review job openings in the United States as of July 2026, with employment types broken down into 5% Locum Tenens, 1% As Needed, 50% Full Time, 31% Part Time, 2% Contract, and 11% Nights. Highlights an 94% Physical, 3% Hybrid, and 3% Remote job distribution, with an average salary of $89,075 per year, or $42.8 per hour.
Utilization Review Nurse | Full Time

Utilization Review Nurse | Full Time

Lancesoft INC

Las Vegas, NV • On-site

$41 - $60/hr

Full-time

Medical, Dental, Life

Posted 14 days ago

Job description

Job Description – Utilization Review Nurse

Position Summary
The Utilization Review Nurse is responsible for reviewing patient admissions and ongoing hospital stays to ensure the delivery of medically necessary, appropriate, and cost-effective care. This role evaluates clinical documentation against established utilization review criteria, payer requirements, and regulatory standards while collaborating with physicians, case managers, and interdisciplinary teams to optimize patient outcomes and resource utilization.

Key Responsibilities

  • Review patient admissions and continued stays for medical necessity, appropriateness of care, and compliance with payer guidelines.
  • Apply InterQual and Milliman criteria to determine appropriate levels of care.
  • Ensure compliance with Medicare, Medicaid, commercial insurance, and regulatory requirements.
  • Analyze medical records to verify accurate clinical documentation and identify opportunities for improvement.
  • Collaborate with physicians, case managers, clinical documentation specialists, and other healthcare professionals to facilitate appropriate patient care and discharge planning.
  • Participate in utilization management activities, including concurrent reviews, appeals, and denial prevention.
  • Maintain accurate documentation of utilization review findings and recommendations.
  • Monitor resource utilization while supporting quality patient care and organizational goals.
  • Stay current with healthcare regulations, accreditation standards, and utilization management best practices.

Qualifications

Education

  • Graduate of an accredited School of Nursing.

Experience

  • Minimum 5 years of acute care clinical nursing experience.
  • At least 3 years of Utilization Management experience.
  • Minimum 3 years of discharge planning experience in an acute care setting.
  • Experience in Case Management or Clinical Documentation Improvement is preferred.

Licensure & Certifications

  • Current, unrestricted Registered Nurse (RN) license in the State of Nevada.
  • Demonstrated proficiency with InterQual criteria and ability to successfully complete the InterQual examination.
  • Recent experience utilizing Milliman Care Guidelines (MCG).

Required Knowledge & Skills

  • Strong understanding of utilization review principles, payer guidelines, Medicare/Medicaid regulations, and accreditation standards.
  • Excellent clinical assessment and critical thinking skills.
  • Ability to interpret medical records and determine medical necessity.
  • Strong communication, collaboration, and interpersonal skills.
  • Proficiency in electronic medical records (EMR) and Microsoft Office applications.
  • Ability to prepare reports, analyze data, and communicate findings effectively.

Working Conditions

This position is primarily office-based within an acute care hospital environment and requires prolonged computer use, reviewing medical records, and frequent collaboration with clinical teams. Occasional weekend or shift work may be required based on operational needs.
- ST

Company Description

LanceSoft is rated as one of the largest staffing firms in the US by SIA. Our mission is to establish global cross-culture human connections that further the careers of our employees and strengthen the businesses of our clients. We are driven to use the power of our global network to connect businesses with the right people, and people with the right businesses without bias. We provide Global Workforce Solutions with a human touch.
LanceSoft logo

About LanceSoft

Sourced by ZipRecruiter

Established in 2000, LanceSoft is a Certified MBE and Woman-Owned organization. Lancesoft Inc. is one of the highest rated companies in the industry. We have been recognized as one of the Largest Staffing firms and ranked in the top 50 fastest Growing Healthcare Staffing firms in 2022. Lancesoft offers short- and long-term contracts, permanent placements, and travel opportunities to credentialed and experienced professionals throughout the United States. We pride ourselves on having industry leading benefits. We understand the importance of partnering with an expert who values your needs, which is why we're 100% committed to finding you an assignment that best matches your career and lifestyle goals. Our team of experienced career specialists takes the time to understand your needs and match you with the right job Lancesoft has been chosen by Staffing Industry Analysts as one of the Best Staffing Firms to Work for.LanceSoft specializes in providing Registered Nurses, Nurse Practitioners, LPNs/LVNs, Social Workers, Medical Assistants, and Certified Nursing Assistants to work in Acute Care Centers, Skilled Nursing Facilities, Long-Term Care centers, Rehab Facilities, Behavioral Health Centers, Drug & Alcohol Facilities, Home Health & Community Health, Urgent Care Clinics, and many other provider-based facilities.

Industry

Recruiting and staffing services

Company size

1,001 - 5,000 Employees

Headquarters location

Herndon, VA, US

Year founded

2000

Social media

FacebookTwitter

View All LanceSoft Jobs