ABA Utilization Management Clinical Consultant

CVS Health

Clinical Consultant for ABA Utilization Management at CVS Health. Applying clinical skills to assess treatment plans while coordinating healthcare services and improving quality.

Posted 5/14/2026full-timeRemote • Louisiana, Maryland, Mississippi, Montana, North Carolina • 🇺🇸 United StatesMid-LevelSenior💰 $26 - $56 per hourWebsite

About the role

Key responsibilities & impact

Applies critical thinking and is knowledgeable in clinically appropriate treatment, evidence-based care and clinical practice guidelines for Behavioral Health, specific to ABA
Utilizes clinical experience and skills in a collaborative process to assess appropriateness of treatment plans across levels of care, applying evidence-based standards and practice guidelines to treatment where appropriate
Coordinate, monitor and evaluate options to facilitate appropriate healthcare services/benefits for members
Gathers clinical information and applies the appropriate clinical criteria/guideline, policy, procedure and clinical judgment to render coverage
Coordinates with providers and other parties to facilitate optimal care/treatment
Identifies members at risk for poor outcomes and facilitates referral opportunities to integrate with other products, services and/or programs
Identifies opportunities to promote quality effectiveness of healthcare services and benefit utilization

Requirements

What you’ll need

Independent BCBA/LBA
3+ years clinical practice experience, e.g., hospital setting, direct clinical practice experience required
1+ years of Autism treatment/ABA experience required
Ability to multitask, prioritize and effectively adapt to a fast-paced changing environment
Position requires proficiency with computer skills which includes navigating multiple systems and keyboarding

Benefits

Comp & perks

medical, dental, and vision coverage
paid time off
retirement savings options
wellness programs
comprehensive benefits package

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills & Tools

clinical practiceevidence-based caretreatment planningclinical criteriaclinical judgmentAutism treatmentABA therapyhealthcare services coordinationquality effectiveness promotionmultitasking

Soft Skills

critical thinkingcollaborationadaptabilityprioritizationcommunication

Certifications

BCBALBA