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Remote Authorization Utilization Review Bcba Jobs

Centene

Utilization Review Clinician - ABA

$27.02 - $48.55/hr

This is a remote position, but applicants must reside in Florida. Candidates must be BCBA certified ... Performs prior authorization reviews related to BH to determine medical appropriateness in ...

Centene

Utilization Review Clinician - ABA

$27.02 - $48.55/hr

Key Details: This isa remote position, but applicants mustreside in Florida. Candidates must ... Performs prior authorization reviews related to BH to determine medical appropriateness in ...

Charlie Health

Utilization Review Specialist

Nashville, TN · Remote

$62K - $70K/yr

Completes pre-certs and authorizations for virtual IOP clients in a timely manner * Completes peer ... REMOTE Please note that this role is not available to candidates in Alaska, Maine, Washington DC ...

Sunshine Behavioral Health

Utilization Review Specialist

WA · Remote

$55K - $65K/yr

... authorization for treatment services provided by Sunshine Behavioral Health. The Utilization Review Coordinator must be familiar with admissions pre-certification process as well as concurrent and ...

Bracane Co

Utilization Review Nurse

Plano, TX · Remote

***REMOTE - Candidates must be based in Texas: Austin area - Travis/Williamson Counties or Richardson ... This position is responsible for performing initial, concurrent review activities; discharge care ...

Centene

Utilization Review Clinician - ABA

$63K - $87K/yr

Performs prior authorization reviews related to BH to determine medical appropriateness in ... For Enterprise Population Health 2+ years providing ABA services as a BCBA License to practice ...

Silver Cross Hospital

Utilization Review Nurse

New Lenox, IL · On-site +1

$34.73 - $45.15/hr

BSN preferred. 2-5 years previous Utilization Review experience preferred. * Current CPR * Relevant ... Days, Primarily remote; onsite orientation requirement; weekend and holiday rotation; on site ...

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Remote Authorization Utilization Review Bcba information

What is a remote authorization utilization review BCBA?

A Remote Authorization Utilization Review BCBA is a Board Certified Behavior Analyst who works remotely to review and approve treatment plans for clients, typically in the context of Applied Behavior Analysis (ABA) therapy. Their main responsibility is to assess clinical documentation and ensure that the recommended services meet medical necessity criteria and payer guidelines. This role often involves collaborating with clinicians, insurance companies, and families to facilitate the authorization process for behavioral health services. Working remotely allows BCBAs in this position to provide their expertise from any location, using digital tools to conduct reviews and communicate with stakeholders.

What are the key skills and qualifications needed to thrive as a remote authorization utilization review BCBA?

To thrive as a Remote Authorization Utilization Review BCBA, you need board certification as a Behavior Analyst (BCBA), deep knowledge of ABA therapy, and experience with clinical documentation and insurance authorization processes. Familiarity with electronic health record (EHR) systems, payer portals, and healthcare compliance tools is typically required. Strong analytical skills, attention to detail, and effective written communication are essential soft skills for success in this remote role. These competencies ensure accurate authorization reviews, compliance with regulations, and efficient support for patients and providers across virtual settings.

How does a remote authorization utilization review BCBA typically collaborate with healthcare providers and insurers during the review process?

A Remote Authorization Utilization Review BCBA frequently communicates with both healthcare providers and insurance representatives to assess and justify the necessity of ABA services for clients. This involves reviewing clinical documentation, clarifying treatment plans, and sometimes participating in peer-to-peer discussions to support authorization requests. Strong written and verbal communication skills are essential, as much of the collaboration is done via phone, email, or secure portals. Building positive relationships and ensuring clear, evidence-based recommendations can help streamline approvals and improve outcomes for clients.
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Remote Authorization Utilization Review Bcba jobs near you
Infographic showing various Remote Authorization Utilization Review Bcba job openings in the United States as of August 2026, with employment types broken down into 1% As Needed, 81% Full Time, 14% Part Time, 1% Temporary, and 3% Contract. Highlights an 88% Physical, 3% Hybrid, and 9% Remote job distribution.

Utilization Management Coordinator

System One

Baltimore, MD • Remote

Contractor

Medical, Dental, Vision, Life, Retirement

Re-posted 12 hours ago

Job description

UTILIZATION MANAGEMENT COORDINATOR

Location: Remote — client site in Baltimore, MD (21224) Type: Contract (3 months to start; expected extension possible) Schedule: 40 hours/week — must include a weekend day Pay (W2): USD 24.70/H

JOB OVERVIEW

In this role, you’ll support Utilization Management (UM) clinical teams by handling non-clinical administrative work tied to pre-service authorization, utilization review support, care coordination workflows, and quality-of-care processes. You’ll help manage authorization intake, documentation, and provider/member support—while working in a fast-paced environment where schedule flexibility (including weekends) is required.

WHAT YOU’LL DO

  • Provide member/provider administrative support such as benefit verification, authorization creation/management, claims inquiries, and case documentation.

  • Review incoming authorization requests for initial determination and/or triage items for clinical review and resolution.

  • Support day-to-day coordination for the department, including answering/responding to phone calls, taking messages, and responding to basic inquiries.

  • Research information and assist with issue resolution and operational problem-solving.

  • Assist with reporting, data tracking, and organizing/disseminating information (including Continuity of Care processes and tracking Peer-to-Peer reviews).

REQUIRED QUALIFICATIONS

  • High School Diploma (or equivalent)

  • 3+ years of experience in healthcare claims/service areas and/or healthcare office/administrative support

  • Ability to work effectively within a multidisciplinary team (internal and external partners)

  • Strong communication, organization, and customer service skills

  • Strong attention to detail with sound judgment and decision-making

  • Comfortable with web-based tools and Microsoft Office (Word, Excel, PowerPoint)

NICE TO HAVE

  • Knowledge of CPT and ICD-10 coding / medical terminology used in managed care

  • Experience in a managed care environment (health plan / UM support)

  • Phone-heavy/customer support experience

  • Experience with Medicaid/Medicare (government programs)

  • Exposure to tools such as Facets, Guiding Care, and/or NICE CXone

System One, and its subsidiaries including Joulé and Mountain Ltd., are leaders in delivering outsourced services and workforce solutions across North America. We help clients get work done more efficiently and economically, without compromising quality. System One not only serves as a valued partner for our clients, but we offer eligible employees health and welfare benefits coverage options including medical, dental, vision, spending accounts, life insurance, voluntary plans, as well as participation in a 401(k) plan.

System One is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity, age, national origin, disability, family care or medical leave status, genetic information, veteran status, marital status, or any other characteristic protected by applicable federal, state, or local law.

#M-M2 #LI-

Ref: #851-Rockville-S1

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About System One

Sourced by ZipRecruiter

System One helps employers get work done more efficiently and economically without compromising quality. Over our 35+ year history, we've helped connect thousands of talented people with innovative companies. The excitement of a perfect fit motivates us every single day.

Industry

Business consulting services and recruiting and staffing services

Company size

5,001 - 10,000 Employees

Headquarters location

Pittsburgh, PA, US

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