Florida Licensed Utilization Review Clinician
Job Summary
To ensure the medical appropriateness of Applied Behavioral Analysis (ABA) services, the full-time Florida Licensed Utilization Review Clinician will perform reviews of member care and health status, working remotely while adhering to ABA guidelines.
Key responsibilities
- Evaluates member care and health status related to ABA services to ensure medical appropriateness
- Performs prior authorization reviews for behavioral health to determine compliance with ABA regulatory guidelines
- Analyzes behavioral health member data to enhance service quality and utilization
Required qualifications
- Active BCBA certification and one of the following licenses: LCSW, LMHC, LPC, LMFT, LMHP, RN, or equivalent
- Master's degree for behavioral health clinicians
- 2-4 years of related experience, including 2+ years providing ABA services as a BCBA
- Knowledge of ABA services and the behavioral health utilization review process
- Experience collaborating with providers and healthcare teams in ABA services preferred
Complete Job Description
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