IBHS Clinical Care Manager - BCBA

Job Description

Job Description

The IBHS Clinical Care Manager – BCBA serves as a care manager within CBH’s Neurodevelopmental Services team, responsible for ensuring members with Autism Spectrum and related neurodevelopmental disorders receive timely, evidence-based, and outcome-driven behavioral health services.

This role combines utilization and population management, provider engagement, treatment quality monitoring, and cross-system collaboration to promote high-quality, cost-effective care. The CCM-BCBA leverages data and clinical expertise to guide authorization decisions, monitor program quality, and support providers in delivering effective Applied Behavior Analysis (ABA) interventions.

Essential Functions :

Depending upon your team assignment, some or all of these may apply.

• Apply advanced knowledge of behavioral health systems, clinical best practices, and medical necessity criteria to all utilization management activities. Conduct expected number of utilization management activities including, but not limited to, interagency meetings, social determinants interviews, treatment team consultations, and care coordination with providers, members, and families. Authorize, extend, or modify treatment services based on clinical documentation, member need, and established criteria.
• Consult with Physician Advisor, Psychologist Advisor and / or Clinical Supervisor as clinically appropriate.
• Generate denial letters based on physician consults and in accordance with state regulations as needed.
• Complete discharge reviews in a timely manner.
• Work hands on in the community with members, natural supports, and providers.
• Facilitate care coordination with system partners to address social determinants, barriers to wellness, and additional related member needs
• Demonstrate an understanding of Evidence-Based Practices (EBPs) and connect members to appropriate evidence-based treatment at admission, during treatment, and at discharge.
• Monitor members’ progress and treatment duration, promoting the least restrictive and most clinically appropriate service environments.
• Collaborate with other CBH departments to ensure quality of care, promote placement of members in the most appropriate services and to facilitate consistent longitudinal care management.
• Conduct provider meetings at least 4 times per year.
• Participate in supervision, case consultations, and team meetings;
• Maintain thorough, timely, and accurate documentation in CBH’s electronic system consistent with regulatory and organizational standards.
• Understand and participate in grievance / complaint hearings as assigned.
• Respond to care coordination correspondence within 24-48 hours or sooner if necessary.
• Work collaboratively with team members including assisting with the training of newly hired employees as requested, covering work when peers are out of the office as assigned and finding coverage when absent.
• Maintain an accurate daily log of work completed.
• Contribute to projects and other duties as assigned.

Team Specific Responsibilities :

Position Requirements :

Skills :

Applications will be considered on a rolling basis and decisions will be made as soon as appropriate candidates are identified

Work Conditions (including travel, overtime required, physical requirements and occupational exposure) :

U.S. Authorization Requirement :

Equal Employment Opportunity :

Requesting An Accommodation :