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Remote Bcba Autism Utilization Review Jobs in Georgia

Oscar Health

Utilization Review Nurse

Atlanta, GA · Remote

$35 - $45.94/hr

You will report into the Supervisor, Utilization Review. Work Location ... This is a remote position, open to candidates who reside in: Arizona; Florida; Georgia; Illinois;

Behavioral Framework LLC

Remote BCBA

Atlanta, GA · On-site +1

$85K/yr

At Behavioral Framework , we're on a mission to deliver life-changing care for children with Autism ... BCBA) for a hybrid role that combines 75% remote flexibility with company-paid monthly travel to ...

BK Behavior

Remote BCBA Work Your Way

Fayetteville, GA · On-site +1

$93/hr

Board Certified Behavior Analyst (BCBA) Remote (Georgia) We are seeking a Board Certified Behavior ... Experience providing ABA services to individuals with autism or developmental disabilities ...

BK Behavior

Remote BCBA | Work Your Way

Thomasville, GA · On-site +1

$93/hr

Board Certified Behavior Analyst (BCBA) Remote (Georgia) We are seeking a Board Certified Behavior ... Experience providing ABA services to individuals with autism or developmental disabilities ...

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Remote Bcba Autism Utilization Review information

What is the difference between Remote Bcba Autism Utilization Review vs Remote Bcba Autism Case Manager?

AspectRemote Bcba Autism Utilization ReviewRemote Bcba Autism Case Manager
CertificationsBCBA, Autism-specific trainingBCBA, Autism-specific training
Work EnvironmentReviewing medical and insurance documentation remotelyCoordinating care and services remotely
Employer & IndustryHealthcare, insurance companies, therapy providers

Both roles require BCBA certification and focus on autism services, but the Autism Utilization Review primarily involves evaluating insurance claims and authorizations, while the Autism Case Manager coordinates ongoing care and services for clients. Understanding these differences helps professionals choose the role that best fits their skills and career goals.

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For Remote Bcba Autism Utilization Review jobs in Georgia, the most frequently searched job titles are:

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Infographic showing various Remote Bcba Autism Utilization Review job openings in Georgia as of August 2026, with employment types broken down into 1% As Needed, 83% Full Time, 13% Part Time, 2% Contract, and 1% Nights. Highlights an 87% Physical, 3% Hybrid, and 10% Remote job distribution.

Utilization Review Nurse

Atlanta, GA • Remote

Oscar Health
Insurance Services • 1 - 5K employees

6.9

Company rating: 6.9 out of 10

Based on 6 frontline employees who took The Breakroom Quiz

262nd of 315 rated insurance

Respectful managers

Uninterrupted breaks

Learn more about Oscar Healthexternal

$35 - $45.94/hr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 8 days ago

Job description

Hi, we're Oscar. We're hiring a Utilization Review Nurse to join our Utilization Review team.

About the role:

You will perform frequent case reviews, check medical records and speak with care providers regarding treatment as needed. You will make recommendations regarding the appropriateness of care for identified diagnoses based on the research results for those conditions.

You will report into the Supervisor, Utilization Review.

Work Location: This is a remote position, open to candidates who reside in: Arizona; Florida; Georgia; Illinois; Iowa; Kansas; Michigan; Missouri; Nebraska; New Jersey; North Carolina; Ohio; Pennsylvania; South Carolina; Tennessee; Texas; or Virginia. While your daily work will be completed from your home office, occasional travel may be required for team meetings and company events.

Pay Transparency: The base pay for this role is: $35.00 - $45.94 per hour. You are also eligible for employee benefits and monthly vacation accrual at a rate of 15 days per year.

Responsibilities:

  • Complete medical necessity reviews and level of care reviews for requested services using clinical judgment and Oscar Clinical Guidelines, Milliman Care Guidelines
  • Obtain the information necessary (via telephone and fax) to assess a member's clinical condition, and apply the appropriate evidence-based guidelines
  • Meet required decision-making SLAs
  • Refer members for further care engagement when needed
  • Compliance with all applicable laws and regulations
  • Other duties as assigned

Requirements:

  • Active, unrestricted RN licensure from the United States in [state], OR, active compact multistate unrestricted RN license as defined by the Nurse Licensure Compact (NLC)
  • Associate Degree - Nursing or Graduate of Accredited School of Nursing Or Successful completion of Nursing Diploma Program in Accredited School of Nursing
  • Ability to obtain additional state licenses to meet business needs
  • 1+ year of utilization review experience in a managed care setting
  • Strong experience utilizating MCG (Milliman Care Gudielines) or InterQual
  • 1+ years of clinical experience (including at least 1+ year clinical practice in an acute care setting, i.e., ER or hospital)
  • Weekend availability is required; all applicants must be able to work at least one weekend day (Saturday or Sunday) each week.

Bonus points:

  • BSN
  • Previous experience conducting concurrent or inpatient reviews for a managed care plan

This is an authentic Oscar Health job opportunity. Learn more about how you can safeguard yourself from recruitment fraud here. 

At Oscar, being an Equal Opportunity Employer means more than upholding discrimination-free hiring practices. It means that we cultivate an environment where people can be their most authentic selves and find both belonging and support. We're on a mission to change health care -- an experience made whole by our unique backgrounds and perspectives.

Pay Transparency:  Final offer amounts, within the base pay set forth above, are determined by factors including your relevant skills, education, and experience. Full-time employees are eligible for benefits including: medical, dental, and vision benefits, 11 paid holidays, paid sick time, paid parental leave, 401(k) plan participation, life and disability insurance, and paid wellness time and reimbursements.

Artificial Intelligence (AI): Our AI Guidelines outline the acceptable use of artificial intelligence for candidates and detail how we use AI to support our recruiting efforts.

Reasonable Accommodation: Oscar applicants are considered solely based on their qualifications, without regard to applicant's disability or need for accommodation. Any Oscar applicant who requires reasonable accommodations during the application process should contact the Oscar Benefits Team (accommodations@hioscar.com) to make the need for an accommodation known.

California Residents: For information about our collection, use, and disclosure of applicants' personal information as well as applicants' rights over their personal information, please see our Privacy Policy.

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