Wisconsin Licensed Behavioral Consultant

Job Summary

To support Medicaid members' access to care, the fully remote Wisconsin Licensed Behavioral Consultant will review and adjudicate prior authorization requests for behavioral treatment services, ensuring compliance with state policies while collaborating with providers and stakeholders.

Key responsibilities

• Evaluate Medicaid prior authorization requests for medical necessity and eligibility according to state guidelines
• Collaborate with providers to obtain necessary information and provide education on prior authorization requirements
• Enter prior authorization determinations into the Medicaid Management Information System (MMIS) for processing

Required qualifications

• Minimum of 5 years of Behavioral Treatment experience
• Current BCBA license in Wisconsin or ability to obtain it prior to the start date
• Experience working with the Wisconsin Medicaid program or other state Medicaid programs
• Strong organizational skills to manage competing priorities and deadlines
• Ability to effectively interpret and communicate policies and procedures