Louisiana Licensed Utilization Review Clinician

Job Summary

To support the delivery of Applied Behavioral Analysis (ABA) services, the full-time Louisiana Licensed Utilization Review Clinician will perform reviews of member care and health status, ensuring medical appropriateness and compliance with ABA guidelines, in a remote work environment.

Key responsibilities

• Evaluates member care and health status related to ABA services to ensure medical appropriateness
• Performs prior authorization reviews for behavioral health services in accordance with ABA regulatory guidelines
• Analyzes member data to enhance the quality and utilization of ABA services

Required qualifications

• Graduate of an Accredited School of Nursing or Bachelor's degree with 2-4 years of related experience
• Master's degree for behavioral health clinicians required
• License to practice independently as LCSW, LMHC, LPC, LMFT, LMHP, or BCBA required
• Behavioral health clinical knowledge and ability to review ABA Treatment Plans required
• Experience in providing ABA services as a BCBA preferred