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, monitor clinical effectiveness, and interact with healthcare providers, all while working remotely from Florida.
Key responsibilities
- Evaluates member care and health status concerning ABA services to ensure medical appropriateness
- Performs prior authorization reviews related to behavioral health to determine compliance with ABA 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
- Master's degree for behavioral health clinicians is required
- 2-4 years of relevant experience in behavioral health and ABA services
- Knowledge of ABA services and the behavioral health utilization review process is essential
- Experience working with healthcare providers to review ABA-related care services is preferred
Complete Job Description
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