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
Utilization Review • Birmingham, Alabama, United States