Louisiana or Georgia Licensed Utilization Review Clinician
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Job Summary
To ensure the medical appropriateness of Applied Behavioral Analysis (ABA) services, the full-time Louisiana or Georgia Licensed Utilization Review Clinician will perform reviews of member care and health status, monitor clinical effectiveness, and interact with healthcare providers, all 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 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
- Licensure as a BCBA, LCSW, LMHC, LPC, LMFT, LMHP, or RN required
- Behavioral health clinical knowledge and ability to review ABA Treatment Plans required
- Experience working with providers in ABA services preferred
Complete Job Description
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