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Full Time Bcba Utilization Review Jobs in Raleigh, NC

Centene

Psychologist Reviewer

Durham, NC · On-site +1

$87K - $157K/yr

The ideal candidate will also hold a BCBA certification to support our growing markets and ensure ... Interact with network practitioners to provide education on best practice models and utilization ...

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All JobsBcba Utilization Review JobsFull Time Bcba Utilization Review JobsFull Time Bcba Utilization Review Jobs in Raleigh, NC

Full Time Bcba Utilization Review information

See Raleigh, NC salary details

$46.2K

$86.6K

$144.8K

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

As of Aug 27, 2026, the average yearly pay for full time bcba utilization review in Raleigh, NC is $86,588.00, according to ZipRecruiter salary data. Most workers in this role earn between $71,900.00 and $88,000.00 per year, depending on experience, location, and employer.

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.

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 are the most commonly searched types of Bcba Utilization Review jobs in Raleigh, NC?

The most popular types of Bcba Utilization Review jobs in Raleigh, NC are:

What are popular job titles related to Full Time Bcba Utilization Review jobs in Raleigh, NC?

For Full Time Bcba Utilization Review jobs in Raleigh, NC, the most frequently searched job titles are:

What job categories do people searching Full Time Bcba Utilization Review jobs in Raleigh, NC look for?

The top searched job categories for Full Time Bcba Utilization Review jobs in Raleigh, NC are:

Full Time Bcba Utilization Review jobs near you
Infographic showing various Full Time Bcba Utilization Review job openings in Raleigh, NC as of August 2026, with employment types broken down into 1% As Needed, 83% Full Time, 13% Part Time, and 3% Contract. Highlights an 89% Physical, 3% Hybrid, and 8% Remote job distribution, with an average salary of $86,588 per year, or $41.6 per hour.

Utilization Review Specialist

Raleigh, NC • On-site

Lifepoint Health
Health Care and Social Assistance • 10K+ employees

5.9

Company rating: 5.9 out of 10

Based on 272 frontline employees who took The Breakroom Quiz

765th of 894 rated healthcare providers

People enjoy working here

Recommended by students

Recommended by parents

Learn more about Lifepoint Healthexternal

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 9 days ago

Job description


Your experience matters
Lifepoint Behavioral Health is part of Lifepoint Health, a diversified healthcare delivery network with facilities coast to coast. Triangle Springs is a 77-bed behavioral health hospital located in Raleigh, North Carolina, providing care for patients with mental health and substance use disorders. We are driven by a profound commitment to prioritize your well-being so you can provide exceptional care to others. As a Registered Nurse (RN) joining our team, you're embracing a vital mission dedicated to making communities healthier®. Join us on this meaningful journey where your skills, compassion, and dedication will make a remarkable difference in the lives of those we serve.
How you'll contribute
Utilization Review Specialist facilitates clinical reviews on all patient admissions and continued stays. UR analyzes patient records to determine legitimacy of admission, treatment, and length of stay and interfaces with managed care organizations, external reviewers and other payers. UR advocates on behalf of patients with substance abuse, dual diagnosis, psychiatric or emotional disorders to manage care providers for necessary treatment. UR contacts external case managers/managed care organizations for certification of insurance benefits throughout the patient's stay and assists the treatment team in understanding the insurance company's requirements for continued stay and discharge planning.
Job Responsibilities
  • Displays knowledge of clinical criteria, managed care requirements for inpatient and outpatient authorization and advocates on behalf of the patient to secure coverage for needed services
  • Complete pre and re-certifications for inpatient and outpatient services. Reports appropriate denial, and authorization information to designated resource.
  • Actively communicates with interdisciplinary team to acquire pertinent information and give updates on authorizations.
  • Participate in treatment teams to ensure staff have knowledge of coverage and to collect information for communication with agencies.
  • Works with DON to ensure documentation requirements are met.
  • Ensure appeals are completed thoroughly and on a timely basis.
  • Interface with managed care organizations, external reviews, and other payers.
  • Communicate with physicians to schedule peer-to-peer reviews.

What we're looking for
Education: Bachelor's degree required. Master's degree preferred.
Experience: Previous utilization review experience in a psychiatric healthcare facility preferred.
License: Current unencumbered clinical license strongly preferred.
Additional Requirements: CPR certification and Crisis Prevention Training (CPI) preferred.
Why join us
We believe that investing in our employees is the first step to providing excellent patient care. In addition to your base compensation, this position also offers:
Comprehensive Benefits: Multiple levels of medical, dental, and vision coverage for full-time and part-time employees
Financial Protection & PTO: Life, accident, critical illness, hospital indemnity insurance, short- and long-term disability, paid family leave, and paid time off
Financial & Career Growth: Tuition reimbursement and 401(k) retirement package with company match
Employee Well-being: Mental, physical, and financial wellness programs, including Employee Assistance Program and discount programs
Professional Development: Ongoing learning and career advancement opportunities
Additional Perks: Shift differentials and set schedules
EEOC Statement
Lifepoint Behavioral Health is an Equal Opportunity Employer. Lifepoint Behavioral Health is committed to Equal Employment Opportunity for all applicants and employees and complies with all applicable laws prohibiting discrimination and harassment in employment.
About Us
Lifepoint Health is a leader in community-based care and driven by a mission of Making Communities Healthier. Our diversified healthcare delivery network spans 29 states and includes 63 community hospital campuses, 32 rehabilitation and behavioral health hospitals, and more than 170 additional sites of care across the healthcare continuum, such as acute rehabilitation units, outpatient centers and post-acute care facilities. We believe that success is achieved through talented people. We want to create places where employees want to work, with opportunities to pursue meaningful and satisfying careers that truly make a difference in communities across the country.
About the Team
We employ and provide care to people from all walks of life. We are committed to promoting healing, providing hope, preserving dignity and producing value with an inclusive workforce in which diversity is leveraged, respected, and reflective of the patients, family members, customers and team members we serve.
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About LifePoint Health

Sourced by ZipRecruiter

Lifepoint Health serves patients, clinicians, communities and partners across the healthcare continuum. Our diversified healthcare delivery network extends from coast to coast, consisting of community hospitals, rehabilitation and behavioral health hospitals, and additional sites of care.

Industry

Health care and social assistance

Company size

10,000+ Employees

Headquarters location

Brentwood, TN, US

Year founded

1999

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Benefits

Hours and flexibility

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