To ensure the medical appropriateness of Applied Behavioral Analysis (ABA) services, the full-time Licensed Utilization Review Clinician will perform reviews of member care and health status while working remotely within the Eastern or Central Time Zone. Key responsibilities: Evaluates member care and health status related to ABA services to ensure compliance with clinical standards Conducts prior authorization reviews for behavioral health services in accordance with ABA guidelines Analyzes member data to enhance service quality and appropriate utilization of ABA services Required qualifications: Active BCBA certification and one of the following licenses: LCSW, LMHC, LPC, LMFT, LMHP, or RN Master's degree for behavioral health clinicians or equivalent experience in ABA services 2-4 years of related experience in behavioral health or ABA services Knowledge of ABA services and the behavioral health utilization review process Experience working with healthcare providers in reviewing ABA care services is preferred
Licensed Utilization Review Clinician in workfromhome at Unknown Company
This position is listed as full time and able to be worked remotely.