Licensed Clinician, Senior (Board Certified Behavioral Analyst)

Your Role

The Behavioral Health Utilization Management team performs prospective utilization review for our members and correctly applies the guidelines for nationally recognized levels of care. They collaborate directly with the Member, Member's Family, and Interdisciplinary Care Team to achieve consensus and promote positive Member health outcomes through the assessment, planning, implementation, and evaluation of the Member's Care Plan. The Licensed Clinician, Senior will report to the Manager, Behavioral Health Utilization Management. In this role you will be working with both the Utilization and Care Management teams, who provide utilization management, telephonic triage and care management assistance to members requesting access to Applied Behavioral Analysis (ABA) benefit. This role has a primary function of utilization management for our members seeking Behavioral Health Treatment (BHT).

Your Knowledge and Experience

• Master's degree in psychology or a related field
• Possesses an active BCBA certification
• At least 5 years of experience as a BCBA * Expert knowledge of Applied Behavior Analysis and Autism Spectrum Disorders
• Considerable knowledge of Managed Care and the different lines of business
• Demonstrated ability to deliver training to varied audiences and conduct effective meetings
• Experience in a managed health care environment with regards to BHT services
• Ability to identify problems and works towards problem resolution independently, seeking guidance as needed
• Ability to represent the health plan in a professional and knowledgeable fashion
• Ability to express ideas clearly in both written and oral communications
• Ability to develop, organize, analyze, and implement processes and procedures
• Proficiency with Microsoft applications including Word, Excel, Outlook, and Teams
• Effective interpersonal skills