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Utilization Management Bcba Remote Jobs (NOW HIRING)

Allmed Staffing Inc

$20.80/hr

Remote (Must have Compact or TX License) Contract: 06/08/2026 to 09/04/2026 Schedule: Monday - Friday, 8:00 AM - 5:00 PM Position Overview: The Utilization Management LPN supports daily utilization ...

Allmed Staffing Inc

$20.80/hr

Remote (Must have Compact or TX License) Contract: 06/08/2026 to 09/04/2026 Schedule: Monday - Friday, 8:00 AM - 5:00 PM Position Overview: The Utilization Management LPN supports daily utilization ...

Sagility LLC

RN Utilization Management Reviewer

$35 - $40/hr

The Nurse Utilization Management Reviewer has a key role in ensuring the client meets CMS ... May require weekends This is a fully remote work at home role. You must have a secure, private wok ...

Sagility LLC

RN Utilization Management Reviewer

$35 - $40/hr

The Nurse Utilization Management Reviewer has a key role in ensuring the client meets CMS ... May require weekends This is a fully remote work at home role. You must have a secure, private wok ...

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$89.1K

$149K

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

As of Jun 8, 2026, the average yearly pay for utilization management bcba remote 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 are the key skills and qualifications needed to thrive in the Utilization Management Bcba Remote position, and why are they important?

Success as a Utilization Management BCBA (Board Certified Behavior Analyst) Remote requires active BCBA certification, experience in behavior analysis, and strong knowledge of insurance and healthcare utilization review processes. Familiarity with electronic medical record (EMR) systems, claims management software, and telehealth platforms is typically necessary. Exceptional attention to detail, problem-solving abilities, and strong written communication skills help candidates excel in remote collaboration and case review. These skills are critical for accurately assessing treatment plans, ensuring compliance, and supporting quality care delivery across remote settings.

What is a Utilization Management BCBA Remote job?

A Utilization Management BCBA (Board Certified Behavior Analyst) Remote job involves reviewing treatment plans, ensuring the appropriate use of applied behavior analysis (ABA) services, and making recommendations based on medical necessity and insurance guidelines. This role typically requires assessing clinical documentation, collaborating with providers, and supporting authorization decisions. Since it is remote, communication is conducted via phone, email, or virtual meetings. The goal is to ensure quality care while managing costs effectively.

What does a typical workday look like for a Utilization Management BCBA working remotely?

A typical day for a remote Utilization Management BCBA involves reviewing and evaluating treatment plans, making medical necessity determinations, and documenting decisions in compliance with health plan guidelines. You will regularly communicate with healthcare providers, clinicians, and insurance representatives via email or video conferencing to clarify details or request additional information. Collaboration with a team of fellow BCBAs and utilization management staff is common, and you may participate in case discussions or staff meetings online. This role often includes working independently, managing multiple cases at once, and ensuring all documentation meets regulatory and quality standards.

More about Utilization Management Bcba Remote jobs
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Utilization Management Bcba Remote jobs near you
Infographic showing various Utilization Management Bcba Remote job openings in the United States as of May 2026, with employment types broken down into 10% As Needed, 50% Full Time, 20% Part Time, and 20% Contract. Highlights an 92% Physical, 2% Hybrid, and 6% Remote job distribution, with an average salary of $89,075 per year, or $42.8 per hour.
Utilization Management Nurse - Behavioral Health Focus (Remote)

Utilization Management Nurse - Behavioral Health Focus (Remote)

Morgan Stephens

Phoenix, AZ • Remote

$40/hr

Other

Posted 14 days ago

Job description

Job Title: Utilization Management Nurse - Behavioral Health Focus (Remote)

Time Zone Preference:
Pacific or Mountain Time Zone is preferred

Work Schedule:
Tuesday through Saturday, 8:00 AM - 5:00 PM PST

Compensation:
$40 per hour

Position Type:
Temporary to Permanent

Position Summary:
A Managed Care Organization is seeking a Utilization Management Nurse to review provider-submitted service authorization requests and evaluate medical necessity, with a primary focus on behavioral health services. This position plays a key role in ensuring members receive appropriate and timely care by performing prior authorizations and concurrent reviews.

Day-to-Day Responsibilities:

  • Review provider submissions for prior service authorizations, particularly in behavioral health

  • Evaluate requests for medical necessity and appropriate service levels

  • Provide concurrent review and prior authorization according to internal policies

  • Identify appropriate benefits and determine eligibility and expected length of stay

  • Collaborate with internal departments, including Behavioral Health and Long Term Care, to ensure continuity of care

  • Refer cases to medical directors as needed

  • Maintain productivity and quality standards

  • Participate in staff meetings and assist with onboarding of new team members

  • Foster professional relationships with internal teams and provider partners

Must-Have Requirements:

  • Background in Behavioral Health services and/or experience with a Managed Care Organization (MCO) in Utilization Management

Licensure Requirements:

  • Active, unrestricted RN, LPN, LCSW, or LPC license

Required Education and Experience:

  • Completion of an accredited Registered Nursing program (or equivalent combination of experience and education)

  • 2 years of clinical experience, preferably in hospital nursing, utilization management, or case management

Knowledge, Skills, and Abilities:

  • Understanding of state and federal healthcare regulations

  • Experience with InterQual and NCQA standards

  • Strong organizational, communication, and problem-solving skills

  • Proficient in Microsoft Office and electronic documentation systems

  • Ability to work independently and manage multiple priorities

  • Professional demeanor and commitment to confidentiality and compliance with HIPAA standards

  • Team-oriented with the ability to build and maintain positive working relationships

Apply