ABA UM Clinical Consultant

Das ist der Job

Coordinates with providers and other parties to facilitate optimal care/treatment.

Darum lohnt es sich

Coordinate, monitor and evaluate options to facilitate appropriate healthcare services/benefits for members. Identifies opportunities to promote quality effectiveness of healthcare services and benefit utilization.

Consults and lends expertise to other internal and external constituents in the coordination and administration of the utilization/benefit management function. We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families.

This full‑time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well‑being of colleagues and their families.

The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility.

Position Summary 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.

Gathers clinical information and applies the appropriate clinical criteria/guideline, policy, procedure and clinical judgment to render coverage. Identifies members at risk for poor outcomes and facilitates referral opportunities to integrate with other products, services and/or programs. This is a remote position.

Required Qualifications • Licensed independent behavioral health clinician with KY licensure (LCSW, LPCC, LMFT, LPAT, LP, LBA) or a Registered Nurse (RN) with a KY or compact license with psychiatric specialty or behavioral health experience. • 3+ years clinical practice experience, e.g., hospital setting, direct clinical practice experience required • 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 • Schedule is Monday-Friday, 8:00am-5:00pm EST with flexibility to work outside of the standard schedule based on business needs Preferred Qualifications • Managed care/utilization review experience preferred • Independent BCBA/LBA preferred Education • Master’s Level of Education resulting in independent Behavioral Health licensure (LCSW, LPCC, LMFT, LPAT, LP, LBA) or an Associate’s degree in Nursing with a KY or compact state Registered Nurse (RN) License with psychiatric specialty or behavioral health experience.

Anticipated Weekly Hours 40 Time Type Full time Pay Range The typical pay range for this role is: $26.01 - $56.14 This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls.

The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above.

We anticipate the application window for this opening will close on: 04/30/2026 Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.