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Remote Bcba Utilization Review Jobs (NOW HIRING)

Gateway Rehab

Utilization Review Liaison - REMOTE

... utilization reviews, and collaborating with clinical teams and insurance providers to support treatment coverage and reimbursement. This position is fully remote and offers the opportunity to make a ...

Sentara Healthcare

UTILIZATION REVIEW NURSE

Norfolk, VA · On-site +1

The Utilization Review Nurse is responsible for utilization management services within the scope of ... For positions that are available as remote work, Sentara Health employs associates in the following ...

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 ...

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Remote Bcba Utilization Review information

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$47.5K

$89.1K

$149K

How much do remote bcba utilization review jobs pay per year?

As of Sep 10, 2026, the average yearly pay for remote 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 a Remote BCBA Utilization Review?

Remote BCBA Utilization Review jobs involve Board Certified Behavior Analysts (BCBAs) who review and assess the medical necessity and effectiveness of Applied Behavior Analysis (ABA) therapy services, usually for insurance companies or healthcare organizations. These professionals work remotely to evaluate clinical documentation, ensure compliance with treatment guidelines, and approve or deny service requests based on established criteria. The role helps ensure that clients receive appropriate care while also managing costs for payers. Strong analytical and communication skills are essential, as is up-to-date BCBA certification.

What are the key skills and qualifications needed to thrive as a Remote BCBA Utilization Review?

To excel as a Remote BCBA Utilization Review specialist, you need Board Certified Behavior Analyst (BCBA) certification, in-depth knowledge of applied behavior analysis (ABA), and experience with clinical documentation standards. Familiarity with electronic health record (EHR) systems, utilization review platforms, and insurance authorization processes is typically required. Strong analytical thinking, attention to detail, and effective written communication distinguish top performers in this role. These competencies ensure accurate service reviews, compliance with payer requirements, and support for quality client care in a remote environment.

What are some common challenges faced by a Remote BCBA Utilization Review professional, and how can they be managed?

Remote BCBA Utilization Review professionals often encounter challenges such as balancing thorough case evaluations with productivity targets and adapting to varying documentation standards from different providers. Effective time management and strong communication skills are key to addressing these challenges. Additionally, staying current with payer guidelines and collaborating closely with clinical teams can help ensure accurate and efficient reviews, ultimately supporting high-quality care for clients.

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

AspectRemote Bcba Utilization ReviewRemote Bcba Case Manager
CertificationsBCBA, possibly additional utilization review credentialsBCBA, case management certifications often preferred
Work EnvironmentReviewing medical and treatment plans remotely, focusing on insurance and authorizationCoordinating care, managing cases, and supporting clients remotely
Employer & IndustryHealthcare, insurance companies, behavioral health providersBehavioral health agencies, healthcare organizations

Both roles require BCBA certification and involve remote work, but the Utilization Review focuses on evaluating treatment plans for insurance approval, while the Case Manager manages ongoing client care and services. Understanding these differences helps professionals choose the right career path in behavioral health.

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Remote Bcba Utilization Review jobs near you
Infographic showing various Remote Bcba Utilization Review job openings in the United States as of September 2026, with employment types broken down into 73% Full Time, 15% Part Time, and 12% Contract. Highlights an 100% Remote job distribution, with an average salary of $89,075 per year, or $42.8 per hour.

Utilization Review Liaison - REMOTE

Remote

Gateway Rehab
Health Care and Social Assistance • 501 - 1,000 employees
Learn more about Gateway Rehabexternal

Full-time

Medical

Posted 8 days ago

Job description

Job Type
Full-time
Description
Gateway Rehab Center (GRC) is hiring a full-time Utilization Review Liaison! In this important administrative and clinical support role, you will help ensure patients receive the appropriate level of care by coordinating authorizations, conducting utilization reviews, and collaborating with clinical teams and insurance providers to support treatment coverage and reimbursement. This position is fully remote and offers the opportunity to make a meaningful impact on patient access to care from your home office. To be considered for the position, you must live within the Pittsburgh, PA area or surrounding counties.
If you're detail-oriented, organized, and enjoy working at the intersection of patient care, insurance, and healthcare operations, keep reading!
Why You'll Love Working at GRC
  • Mission-driven work supporting individuals and families impacted by addiction.
  • Opportunity to play a vital role in ensuring access to treatment services.
  • Collaborative environment working alongside clinical, admissions, and billing teams.
  • Meaningful work that helps patients receive the care they need throughout their recovery journey.
  • Comprehensive benefits package, including contribution toward the medical insurance plan of your choice: Highmark or UPMC, plus access to employee discount programs and additional supportive benefits!

Why This Role is Important to SUD Treatment
GRC's Utilization Review team is changing lives, and as a Utilization Review Liaison, you'll be at the forefront of this effort. By securing and maintaining treatment authorizations, monitoring coverage, and advocating for continued care when needed, you help remove barriers to treatment and ensure patients have access to critical recovery services. Your work directly supports quality patient care, treatment continuity, and organizational success. This is more than an administrative role. It's an opportunity to make a lasting impact on recovery every day.
Responsibilities:
  • Gather clinical information needed for concurrent and retrospective reviews.
  • Complete concurrent and retrospective review processes with payors for treatment authorization.
  • Collaborate with utilization review team members and clinical staff to prepare for reviews and maintain daily workflow.
  • Enter authorization information into the patient database.
  • Communicate authorization status updates to clinical staff.
  • Monitor patients' last covered day of treatment and notify appropriate staff of upcoming coverage expirations.
  • Investigate and resolve issues involving incomplete or missing authorizations.
  • Identify errors that could negatively impact reimbursement for patient treatment.
  • Collaborate with multiple departments to ensure continuity of treatment coverage.
  • Educate clinical and support staff regarding county-funded, managed care, and commercial insurance procedures.
  • Complete peer-to-peer reviews as needed.
  • Communicate discharge information to funding sources when required.
  • Coordinate with clinical teams to ensure funding sources are notified of patient status changes.
  • Investigate denied claims and assist in efforts to recover payment for services rendered.
  • Attend managed care provider meetings as needed.
  • Participate in required GRC trainings and in-service programs.

What You Bring
  • Strong understanding of utilization review, insurance authorization processes, and managed care practices.
  • Excellent verbal and written communication skills.
  • Strong organizational skills and attention to detail.
  • Ability to manage multiple priorities in a fast-paced environment.
  • General understanding of ASAM Criteria.
  • Familiarity with substance use disorder, mental health, and behavioral healthcare treatment services.
  • Strong problem-solving and critical-thinking abilities.
  • Proficiency in Microsoft Office applications, including Word, Excel, and email systems

Requirements
What Do We Require?
  • Bachelor's degree.
  • Familiarity with drug and alcohol treatment, mental health treatment, and/or managed care processes.
  • Proficiency with computer systems and Microsoft Office applications.

Preferred Qualifications
  • Master's degree.
  • Registered Nurse (RN) with current Pennsylvania licensure.
  • Previous experience with utilization review, managed care, insurance authorizations, or healthcare reimbursement processes.

Additional Requirements
  • Pass a PA Criminal Background Check.
  • Obtain PA Child Abuse and FBI Fingerprinting Clearances.
  • Pass a Drug Screen.
  • Complete a 2-Step TB Test.

What Are the Work Conditions?
  • Remote.
  • Prolonged periods of sitting and working on a computer.
  • Minimal physical demands.
  • Significant attention to detail required.
  • Mental demands include problem-solving complex coverage issues, analyzing authorization requirements, and coordinating information across multiple departments.

GRC is an Equal Opportunity Employer committed to diversity, equity, inclusion, and belonging. We value diverse voices and lived experiences that strengthen our mission and impact.

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