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Remote Behavioral Health Utilization Review Jobs in Boca Raton, FL

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Remote Behavioral Health Utilization Review information

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How much do remote behavioral health utilization review jobs pay per hour?

As of Sep 2, 2026, the average hourly pay for remote behavioral health utilization review in Boca Raton, FL is $40.12, according to ZipRecruiter salary data. Most workers in this role earn between $31.73 and $46.06 per hour, depending on experience, location, and employer.

What is a remote behavioral health utilization review?

A Remote Behavioral Health Utilization Review job involves evaluating behavioral health treatment plans and services to ensure they meet insurance guidelines, medical necessity, and regulatory requirements. Professionals in this role review clinical documentation, assess patient needs, and collaborate with healthcare providers to determine appropriate levels of care. They work remotely, often for insurance companies or healthcare organizations, to authorize or deny coverage based on established criteria. Strong clinical knowledge, attention to detail, and communication skills are essential for success in this role.

What are the typical daily responsibilities for someone working in remote behavioral health utilization review?

In a Remote Behavioral Health Utilization Review role, your daily tasks often include reviewing clinical documentation, assessing medical necessity for behavioral health services, and making authorization or denial recommendations according to established guidelines. You’ll frequently interact with providers, case managers, and insurance representatives to gather information and clarify care requests. Additionally, your day may involve documenting decisions, participating in case review meetings, and staying updated on evolving policies. Working remotely, you'll communicate primarily via secure electronic systems, phone, and video conferencing. This structure typically offers flexibility but also requires strong self-motivation and organization.

What are the key skills and qualifications needed to thrive in remote behavioral health utilization review, and why are they important?

To excel in Remote Behavioral Health Utilization Review, candidates generally need a clinical background such as a nursing or social work license, strong analytical skills, and experience with behavioral health diagnoses and treatment planning. Familiarity with utilization management software, electronic health records (EHRs), and insurance coding systems is often required, along with certifications like CCM (Certified Case Manager) or URAC accreditation being valued. Excellent communication, critical thinking, and organizational skills help professionals handle complex cases and collaborate effectively in a virtual team environment. These competencies ensure accurate review of mental health services, compliance with payer requirements, and optimal patient outcomes.

What are the most commonly searched types of Behavioral Health Utilization Review jobs in Boca Raton, FL?

The most popular types of Behavioral Health Utilization Review jobs in Boca Raton, FL are:

What are popular job titles related to Remote Behavioral Health Utilization Review jobs in Boca Raton, FL?

For Remote Behavioral Health Utilization Review jobs in Boca Raton, FL, the most frequently searched job titles are:

What cities near Boca Raton, FL are hiring for Remote Behavioral Health Utilization Review jobs?

Cities near Boca Raton, FL with the most Remote Behavioral Health Utilization Review job openings:

Acquisition & Utilization Specialist

Veterans Health Administration

West Palm Beach, FL • On-site, Remote

$79K - $103K/yr

Full-time

This job post has expired today. Applications are no longer accepted.


Veterans Health Administration rating

8.1

Company rating: 8.1 out of 10

Based on 1,006 frontline employees who took The Breakroom Quiz

66th of 898 rated healthcare providers


Job description

Summary
West Palm Beach VA Medical Center is looking for an Acquisition Utilization Specialist. You will serve as the medical center liaison and advisor on contract related services focusing on critical clinical and healthcare services, product acquisition and support services required by project managers, program managers, upper management and stakeholders on all aspects of procurement for a wide variety of items to include specialized services.
Learn more about this agency
Duties
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The Acquisition Program Specialist is a VA HCS subject matter expert in the acquisition process. Develops procedures, policies, and supporting artifacts to ensure procurement activities are consistent with Federal Acquisition Regulations (FAR), VA Acquisitions Regulations (VAAR) and other federal procurement laws and regulations. Coordinates with Network Contracting Activity (NCA) and VA HCS leadership, clinical service customers, Contracting Officers Representatives (CORS), logistics staff, and other stakeholders to develop and execute acquisition strategies. Conducts analyses and recommends courses of actions to ensure that various clinical and administrative service requirements have addressed considerations such as construction, budgeting, supporting manpower and other factors.
Additional Duties Include But Not Limited To:
  • Develops local policies, procedures, SOPs, and associated training materials ensuring they align with federal procurement laws and regulations.
  • Provides training to the facility CORs on procurement policies and new processes procedures related to procurement within the Federal government.
  • Establishes, expedites, and reviews consolidation of, all procurement packages, including unique, emergent, and complex requirements, to meet timely and technical needs of assigned acquisitions.
  • Independently develops performance work statements and objectives, cost benefit analysis, gap analysis, sole source justifications, past performance, quality assurance surveillance plans (QASP), market research, independent government estimates, evaluation criteria, options, funding, delivery schedules, lead times, and reporting requirements.
  • Reviews procurement documents for accuracy, adequacy, and completeness, and assists service line managers as needed to ensure the final documents are acceptable.
  • Develops sole source justifications in relation to cost, limited availability or unusual nature, when the health care resource need is either unique in the medical community, or is subject to maximum utilization only through health care resources contracting, and identifies other alternative sources that exist within the local, regional or national geographical areas.
  • Develops and implements processes and procedures as changes are made to the VHA Procurement Manual.
  • Works collaboratively with clinical chiefs, healthcare professionals at affiliates or within the community to discuss clinical needs to develop health resources, direct sharing agreements with military treatment facilities (MTFs), and Department of Defense (DOD) organizational components.
  • Develops and conducts presentations/recommendations to VA HCS senior leadership as well as other internal and external stakeholders.
  • Furnishes instructions and explanations on new regulations and procedures.
  • Develops and analyzes local and regional reports.
  • Makes presentations/recommendations to senior management officials regarding the contracting support of the facility.
  • Prepares reports or briefs, contract data for meetings, inspections, audits and in-progress reviews.
  • Directs facility-wide procurements as assigned through the facility Equipment Committee in support of the three to five year strategic acquisition plan.
  • Negotiates performance requirements among multiple sites and service lines in order to obtain agreement, standardize enterprise equipment, supply, and/or service requirements in support of facility strategic acquisition plans.
  • Leads the development of facility performance work statements and objectives, cost benefit analysis, gap analysis, sole source justifications, past performance, quality assurance surveillance plans (QASP), market research, independent government estimates, evaluation criteria, options, funding, delivery schedules, lead times, and reporting requirements.
  • Reviews facility procurement documents for accuracy, adequacy, and completeness.
  • Submits funding 2237 to the Electronic Contract Management System (eCMS) or equivalent system to cover requirements for facility contracts.
  • Ensures timely certification of payments for services rendered through collaboration with the office of the Facility Chief Supply Chain Officer.
  • Manages all tactical/operational responsibilities from procure to pay pertaining to the designated contracts.
  • Prepares and processes requisitions and procurement packages to the NCA for award for facility wide fund control activities.

Work Schedule: Monday through Friday, 8:00 am to 4:30 pm.
Virtual: This is not a virtual position.
Position Description/PD#: Acquisition & Utilization Specialist/PD99810S
Relocation/Recruitment Incentives: Not Authorized.
Critical Skills Incentive (CSI): Not Approved.
Permanent Change of Station (PCS): Not Authorized.
Requirements
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Conditions of employment
  • You must be a U.S. Citizen to apply for this job
  • Selective Service Registration is required for males born after 12/31/1959
  • Subject to background/security investigation
  • Selected applicants will be required to complete an online onboarding process. Acceptable form(s) of identification will be required to complete pre-employment requirements (https://www.uscis.gov/i-9-central/form-i-9-acceptable-documents). Effective May 7, 2025, driver's licenses or state-issued identification cards that are not REAL ID compliant cannot be utilized as an acceptable form of identification for employment.
  • Participation in the seasonal influenza vaccination program is a requirement for all Department of Veterans Affairs Health Care Personnel (HCP)

As a condition of employment for accepting this position, you will be required to serve a 1-year probationary period or 2-year trial period during which we will evaluate your fitness and whether your continued employment advances the public interest. In determining if your employment advances the public interest, we may consider:
  • your performance and conduct;
  • the needs and interests of the agency;
  • whether your continued employment would advance organizational goals of the agency or the Government; and
  • whether your continued employment would advance the efficiency of the Federal service.

Upon completion of your probationary period or trial period, your employment will be terminated unless you receive certification, in writing, that your continued employment advances the public interest.
Qualifications
To qualify for this position, applicants must meet all requirements by the closing date of this announcement, 08/31/2026.
Time-In-Grade Requirement: Applicants who are current Federal employees and have held a GS grade any time in the past 52 weeks must also meet time-in-grade requirements by the closing date of this announcement. For a GS-11 position you must have served 52 weeks at the GS-9. The grade may have been in any occupation, but must have been held in the Federal service. An SF-50 that shows your time-in-grade eligibility must be submitted with your application materials. If the most recent SF-50 has an effective date within the past year, it may not clearly demonstrate you possess one-year time-in-grade, as required by the announcement. In this instance, you must provide an additional SF-50 that clearly demonstrates one-year time-in-grade. Note: Time-In-Grade requirements also apply to former Federal employees applying for reinstatement as well as current employees applying for Veterans Employment Opportunities Act of 1998 (VEOA) appointment.
You may qualify based on your experience and/or education as described below:
  • Specialized Experience: You must have one year of specialized experience equivalent to at least the next lower grade GS-09 in the normal line of progression for the occupation in the organization. Examples of specialized experience would typically include, but are not limited to: handling contract related services, product acquisition, and procurement of items in a healthcare environment; overseeing contracts including pre-award and post-award; preparing procurement packages with unique, emergent and complex requirements including development of requirement documents (e.g. performance work statements and objectives, cost benefit analysis, gap analysis, sole source justifications, past performance, market research, etc.); developing sole source justifications; developing and analyzing reports to make recommendations on acquisition and contracting issues; participating in negotiations with other officials throughout all phases of contract administration; and monitoring expenditures and reporting on deviations from contract terms. OR,
  • Education: Applicants may substitute education for the required experience. To qualify based on education for this grade level you must have a Ph.D. or equivalent doctoral degree or three (3) full years of progressively higher-level graduate education leading to such a degree or LL.M., if related, that provided the knowledge, skills, and abilities necessary to do the work of this position. (TRANSCRIPTS REQUIRED) OR,
  • Combination: An equivalent combination of successfully completed graduate education and specialized experience, as described above, which meets the total qualification requirement for the GS-11 grade level. (TRANSCRIPTS REQUIRED)

Preferred Experience - Possess a Contracting Officers Representatives (FAC COR Level II or Higher) , prior VA purchase card holder, VA Acquisition knowledge, Federal Acquisition Regulations and VA Acquisitions Regulations knowledge. Experience with The TAC and NAC ordering.
You will be rated on the following Competencies for this position:
  • Technical Competence: Uses knowledge that is acquired through formal training or extensive on-the-job experience to perform one's job; works with, understands, and evaluates technical information related to the job; advises others on technical issues.
  • Contracting/Procurement: Knowledge of various types of contracts, techniques, or requirements (for example, Federal Acquisitions Regulations) for contracting or procurement, and contract negotiation and administration.
  • Control of Funds: Knowledge of the principles, procedures, and requirements for maintaining control and accountability of obligations and expenditures for all appropriations and fund accounts (for example, revolving, non-appropriated, multiyear, and single-year appropriations).
  • Communication: Expresses information (for example, ideas or facts) to individuals or groups effectively, taking into account the audience and nature of the information (for example, technical,-sensitive, controversial); makes clear and convincing presentations; listens to others, attends to nonverbal cues, and responds appropriately.
  • Negotiation: Works with others towards an agreement that may involve exchanging specific resources or resolving differences.
  • Reasoning: Identifies rules, principles, or relationships that explain facts, data, or other information; analyzes information and makes correct inferences or draws accurate conclusions.

Experience refers to paid and unpaid experience, including volunteer work done through National Service programs (e.g., Peace Corps, AmeriCorps) and other organizations (e.g., professional; philanthropic; religions; spiritual; community; student; social). Volunteer work helps build critical competencies, knowledge, and skills and can provide valuable training and experience that translates directly to paid employment. You will receive credit for all qualifying experience, including volunteer experience.
Note: A full year of work is considered to be 35-40 hours of work per week. Part-time experience will be credited on the basis of time actually spent in appropriate activities. Applicants wishing to receive credit for such experience must indicate clearly the nature of their duties and responsibilities in each position and the number of hours a week spent in such employment.
Physical Requirements: Work is primarily sedentary in nature. Requires occasional travel to conduct inspections of contract facilities or motor vehicles providing contracts for healthcare resources to ensure joint commission and safety requirements are met. Work is performed primarily in an office setting with adequate lighting, heating, and ventilation.
For more information on these qualification standards, please visit the United States Office of Personnel Management's website at https://www.opm.gov/policy-data-oversight/classification-qualifications/general-schedule-qualification-standards/.
Education
A transcript must be submitted with your application if you are basing all or part of your qualifications on education.
Note: Only education or degrees recognized by the U.S. Department of Education from accredited colleges, universities, schools, or institutions may be used to qualify for Federal employment. You can verify your education here: http://ope.ed.gov/accreditation/. If you are using foreign education to meet qualification requirements, you must send a Certificate of Foreign Equivalency with your transcript in order to receive credit for that education. For further information, visit: https://sites.ed.gov/international/recognition-of-foreign-qualifications/.
Additional information
This job opportunity announcement may be used to fill additional vacancies.
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About Veterans Health Administration

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The Veterans Health Administration (VHA) is the largest integrated health care system in the United States, serving millions of Veterans each year. Located in Phoenix, AZ, and many other parts of the US, the VHA operates under the Department of Veteran Affairs, as suggested by their official website va.gov. The VHA is dedicated to providing the highest level of comprehensive care to its veterans. The organization offers a broad spectrum of medical, surgical, and rehabilitative care, including mental health services, research, and pharmacy benefits.

Industry

Health care and social assistance

Company size

10,000+ Employees

Headquarters location

Phoenix, AZ, US