BCBA Licensed Utilization Review Specialist

Job Summary

To support a growing healthcare practice, the contract-to-hire BCBA Licensed Utilization Review Specialist will perform prospective, concurrent, and retrospective reviews of Applied Behavior Analysis (ABA) services, ensuring medical necessity and appropriateness while working remotely.

Key responsibilities

• Perform reviews to determine authorization and medical necessity for ABA services
• Evaluate treatment plans and clinical documentation for appropriateness and compliance with guidelines
• Collaborate with internal teams and providers to support case decision-making and benefit determinations

Required qualifications

• Master's Degree or higher in Behavior Analysis, Psychology, Education, or a related field
• Active Board Certified Behavior Analyst (BCBA) certification in good standing
• 3-5+ years of clinical ABA experience, including direct patient care
• Experience in developing ABA treatment plans and conducting functional behavior assessments
• Active state licensure as a Behavior Analyst where applicable