Licensed Utilization Review Clinician

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 to ensure medical appropriateness

Performs prior authorization reviews for behavioral health to determine medical appropriateness according to ABA guidelines

Analyzes behavioral health member data to enhance quality and appropriate utilization of services

Required Qualifications, Training, and Education

Graduate of an Accredited School of Nursing or Bachelor's degree with 2 - 4 years of related experience

Independent licensure as required by state, such as LCSW, LMHC, LPC, LMFT, LMHP, RN, or BCBA

Behavioral health clinical knowledge and experience in reviewing ABA Treatment Plans

Knowledge of ABA services and the behavioral health utilization review process

Preferred experience working with providers and healthcare teams regarding ABA services