Job Summary
A company is looking for a Utilization Review Clinician - ABA.
Key Responsibilities
- Evaluates member's care and health status related to Applied Behavioral Analysis (ABA) services for medical appropriateness
- Performs prior authorization reviews for behavioral health to ensure compliance with ABA regulatory guidelines
- Analyzes 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
- Licensure as a Clinical Social Worker, Mental Health Counselor, Professional Counselor, or equivalent required
- Behavioral health clinical knowledge with the ability to review ABA Treatment Plans
- Knowledge of ABA services and the behavioral health utilization review process
- Experience working with healthcare providers in relation to Applied Behavior Analysis Services preferred
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