To ensure the medical appropriateness of Applied Behavioral Analysis (ABA) services, the full-time Florida Licensed Utilization Review Clinician will conduct reviews of member care and health status, working remotely while residing in Florida. Key responsibilities Evaluates member care and health status related to ABA services to ensure medical appropriateness and compliance with clinical standards Performs prior authorization reviews for behavioral health services in accordance with ABA regulatory guidelines Analyzes behavioral health member data to enhance service quality and appropriate utilization Required qualifications Graduate of an Accredited School of Nursing or Bachelor's degree with 2-4 years of related experience BCBA certification and 2+ years providing ABA services required Knowledge of ABA services and behavioral health utilization review processes Independent licensure as a clinical social worker, mental health counselor, professional counselor, or similar required Experience collaborating with healthcare providers on ABA service reviews preferred
Florida Licensed Utilization Review Clinician in workfromhome at Unknown Company
This position is listed as full time and able to be worked remotely.