Licensed Utilization Review Clinician
Job Summary
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
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