Utilization Review Clinician – ABA
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Job Description
Utilization Review Clinician conducting prior authorization reviews for ABA treatment services. Evaluating clinical documentation for medical necessity with a focus on member care efficiency.
Responsibilities:
- conduct prior authorization reviews for ABA treatment services
- evaluate clinical documentation for medical necessity
- monitor clinical effectiveness and efficiency of member's care according to ABA guidelines
- analyze BH member data to improve service utilization
- interact with BH healthcare providers to discuss care and services
Requirements:
- Graduate of an Accredited School of Nursing or Bachelor's degree and 2-4 years of related experience
- 2+ years providing ABA services as a BCBA
- License to practice independently, and/or have obtained the state required licensure (BCBA)
- Behavioral health clinical knowledge and ability to review ABA Treatment Plans
- Knowledge of ABA services and BH utilization review process
Benefits:
- competitive pay
- health insurance
- 401K and stock purchase plans
- tuition reimbursement
- paid time off plus holidays
- flexible approach to work
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