Licensed Utilization Review Clinician

Job Summary

A company is looking for a Utilization Review Clinician - ABA.

Key Responsibilities

• Evaluate member's care and health status related to Applied Behavioral Analysis (ABA) services
• Perform prior authorization reviews for behavioral health to ensure medical appropriateness
• Analyze behavioral health member data to enhance service quality and utilization

Required Qualifications, Training, and Education

• Graduate of an Accredited School of Nursing or Bachelor's degree with 2-4 years of related experience
• License to practice independently or state-required licensure (BCBA) is required
• Master's degree for behavioral health clinicians is preferred
• Knowledge of ABA services and behavioral health utilization review processes is required
• Experience working with providers and healthcare teams related to ABA services is preferred