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Remote Bcba Utilization Review Jobs in Raleigh, NC

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Network Administrator

Durham, NC · Remote

... Remote services/monitoring, Backup maintenance, EndPoint Hardware/Software, Wireless infrastructures, Vendor management. HeavySecurity emphasis. Collect/review network utilization reports: Debug ...

Aerotek

Proposal Writer

Raleigh, NC · On-site +1

Manage version control, review and stakeholder feedback to maintain accuracy and quality * Manage ... Utilization of Monday.com collaboration tool for project tracking and management * Support ...

Aerotek

Proposal Writer

Raleigh, NC · On-site +1

$61K - $71K/yr

Manage version control, review and stakeholder feedback to maintain accuracy and quality * Manage ... Utilization of Monday.com collaboration tool for project tracking and management * Support ...

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All JobsBcba Utilization Review JobsRemote Bcba Utilization Review JobsRemote Bcba Utilization Review Jobs in Raleigh, NC

Remote Bcba Utilization Review information

See Raleigh, NC salary details

$46.2K

$86.6K

$144.8K

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

As of Jul 15, 2026, the average yearly pay for remote 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.

Can you work fully remote as a BCBA?

Remote BCBA utilization review roles are increasingly available, allowing BCBAs to perform assessments, plan development, and supervision tasks remotely using telehealth platforms and secure communication tools. However, some positions may require occasional in-person visits or adherence to state licensing and certification requirements. Overall, many BCBA jobs now offer fully remote options depending on employer policies and client needs.

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.

How can I make 2000 a week working from home?

A Remote BCBA Utilization Review professional can potentially earn $2,000 weekly by working full-time hours, often 40 hours per week, and handling a high volume of cases or reviews. Increasing productivity, gaining specialized certifications, and working for organizations that offer competitive pay rates can help achieve this income level from home.

Is utilization review work from home?

Remote BCBA utilization review positions typically allow professionals to work from home, especially with the increasing adoption of telehealth and digital documentation tools. However, some roles may require occasional in-office visits or meetings, depending on the employer's policies and state regulations. Strong communication skills and familiarity with electronic health records are important for remote work in this field.

How to make $1000 a week remotely?

A Remote BCBA Utilization Review professional can earn $1000 or more weekly by working full-time hours, often 40 hours or more, and charging competitive rates or salaries based on experience and certifications. Increasing billable hours, specializing in high-demand areas, and gaining additional credentials can help boost income in remote behavioral health roles.

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.

What are Remote BCBA Utilization Review jobs?

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 specialist, and why are they important?

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 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 Remote Bcba Utilization Review jobs in Raleigh, NC? For Remote Bcba Utilization Review jobs in Raleigh, NC, the most frequently searched job titles are:
What job categories do people searching Remote Bcba Utilization Review jobs in Raleigh, NC look for? The top searched job categories for Remote Bcba Utilization Review jobs in Raleigh, NC are:
What cities near Raleigh, NC are hiring for Remote Bcba Utilization Review jobs? Cities near Raleigh, NC with the most Remote Bcba Utilization Review job openings:
Remote Bcba Utilization Review jobs near you
Infographic showing various Remote Bcba Utilization Review job openings in Raleigh, NC as of July 2026, with employment types broken down into 1% As Needed, 59% Full Time, 35% Part Time, 1% Temporary, 3% Contract, and 1% Nights. Highlights an 94% Physical, 4% Hybrid, and 2% Remote job distribution, with an average salary of $86,588 per year, or $41.6 per hour.
Dir-Utilization Management-Physical Health (Full-time Remote, Morrisville, NC Based)

Dir-Utilization Management-Physical Health (Full-time Remote, Morrisville, NC Based)

Alliance

Morrisville, NC • On-site, Remote

Full-time

Re-posted 28 days ago

Job description

The Director of Utilization Management (UM) for Physical Health is responsible for administering and coordinating physical health utilization management activities for Alliance. This position ensures the UM Department operates as an integrated department providing a holistic review of member's needs. The position is responsible for overseeing a core component that ensures that individuals receive the correct level and intensity of services that results in positive outcomes. This job also develops systems to monitor the appropriate utilization of both state and Medicaid funds.
This position is full-time remote. Selected candidate must reside in North Carolina and be willing to travel to the home office (Morrisville, NC) for onsite team meetings as needed.
Responsibilities & Duties
Develop and implement Unit goals and objectives
  • Integrate the department and its functions into the organization's primary mission.
  • Ensure the Utilization Management Department serves as an integrated department through effectively collaborating with the Director of Behavioral Health Utilization Management and the Sr. Director of Utilization Management

Manage and Develop Staff
  • Work with Human Resources and the Sr. Director of UM to maintain and retain a highly qualified and well-trained workforce.
  • Ensure staff are well trained in and comply with all organization and department policies, procedures, and business processes.
  • Organize workflows and ensure staff understand their roles and responsibilities.
  • Ensure the department has the needed tools and resources to achieve organizational goals and to support employees and ensure compliance with licensure, regulatory, and accreditation requirements.
  • Actively establish and promote a positive, diverse, and inclusive working environment that builds trust.
  • Ensure all staff are treated with respect and dignity
  • Ensure standards are transparent and applied consistently, impartially, and ethically over time and across all staff members.
  • Work to resolve conflicts and disputes, ensuring that all participants are given a voice.
  • Set goals for performance and deadlines in line with organization goals and vision.
  • Effectively communicate feedback and provide ongoing coaching and mentoring to staff and support a learning environment to advance team skills and professional development.
  • Cultivate and encourage efforts to expand cross-team collaboration and partnership.
  • Effectively utilize and teach to the team how to effectively utilize authorization, claims and per diem data in order to remain within Alliance's Cost of Care plan
  • Supervise UM Physical Health employees to assure accountability and productivity in meeting Department objectives and targets.

Oversee delegated UM vendors
  • Oversee delegated vendors performing utilization reviews for physical health services.
  • Monitor UM vendors for compliance with delegation agreements and corrective action plans.
  • Report analysis of non-compliance when identified.

Oversee the UM Unit reviewing physical health services
  • Ensure consistent application of medical necessity criteria for physical health services.
  • Participate in the development and implementation of department policies and procedures
  • Ensure compliance with performance measures outlined within NC DHB, NC DMH contracts and all accrediting body standards.
  • Protect client rights by ensuring all UM staff are trained and follow due process procedures, including the timely processing of treatment requests.
  • Implement a system to maintain and assure that the authorization of services provided by clinical care staff appropriately address the service needs, types of service, outcomes, and alternatives available to consumers.
  • Refine and evaluate the methods of authorization for services and treatment; develop strategies for accessing alternative to care.
  • Provide education to hospitals, nursing homes and other care providers concerning departmental procedures and requirements for approving length of stay extensions.
  • Analyze and monitor community capacity for service needs, service gaps, and the implementation of evidence based/best practices.
  • Advise on the Alliance Medicaid and Non-Medicaid benefit plans that support the delivery and fidelity of evidence-based practices.
  • Implement and montior systems to detect patterns of over and under utilization and implements corrective plans.
  • Advise the Utilization Management Committee regarding service line trends and operational key performance measures.
  • Perform other related duties as required by the immediate supervisor or other designated Alliance Health administration

Inter-Departmental Collaboration
  • Maintain accessible and close working relationships with all applicable department heads and decision makers to develop a more coordinated and streamlined service delivery system for individuals and families throughout the service area.
  • Identify opportunities for collaboration on inter-departmental projects that reduces duplication and ineffenciencies across the system.
  • Work with the Medical Directors with decision making of medical necessity cases, specialists, and primary care physicians

Minimum Education & Experience
Bachelors in Nursing with seven (7) years' post-degree experience, including at least two (2) years of supervisory experience and two (2) years Utilization Management or substantially equivalent experience;
OR
Master's degree in Nursing and five (5) years' experience including at least two (2) years of supervisory experience and two (2) years Utilization Management experience or substantially equivalent experience.
Knowledge, Skills, & Abilities
  • Must be knowledgeable in Utilization Management managed care principles and strategies
  • Knowledge of physical health and co-morbid health conditions
  • Knowledge of diagnostic treatment guidelines/protocols, level of care criteria
  • Authorization/re-authorization Utilization Management standards
  • Ability to analyze data and develop corresponding strategies
  • Ability to develop and document workflows
  • Written and oral communication skills
  • Ability to analyze effectiveness of processes and make adjustments to developed processes.
  • Experience in acute clinical utilization review
  • Experience in related duties in the delivery of patient care, management of patient care providers, or project management in a healthcare environment
  • Demonstrates ability to interact with a wide variety of individuals, and handle complex and confidential sensitive situations.
  • Able to lead, delegate and problem solve
  • Proficient in the use of computer and multiple software programs.
  • Ability to assist appeal efforts when medical care is denied by various payor entities in a timely fashion.

Employment for this position is contingent upon a satisfactory background check, which will be performed after acceptance of an offer of employment and prior to the employee's start date.
Exact compensation will be determined based on the candidate's education, experience, external market data and consideration of internal equity.
Equal Opportunity Employer
This employer is required to notify all applicants of their rights pursuant to federal employment laws.
For further information, please review the Know Your Rights notice from the Department of Labor.

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