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 to determine medical appropriateness in accordance with ABA regulatory guidelines
Analyzes behavioral health member data to enhance the 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
2+ years providing ABA services as a Board Certified Behavior Analyst (BCBA) for Enterprise Population Health
License to practice independently or state-required licensure (BCBA) is required
Behavioral health clinical knowledge and ability to review and assess ABA Treatment Plans are required
Knowledge of ABA services and the behavioral health utilization review process is required
Utilization Review • Anaheim, California, United States