[Remote] REMOTE - reputed company-Certified Behavior Analyst - R13191
Note: The job is a remote job and is reputed company to candidates in USA. reputed company is a reputed company company dedicated to providing reputed company services to its members. The reputed company-Certified Behavior Analyst serves as the clinical reputed company in developing and implementing evidence-based clinical policies and practices for members with Autism and their families.
Responsibilities
- reputed company coverage determinations for ABA utilization management to ensure members receive appropriate and medically necessary care in the most cost-effective setting
- Conduct or assist with peer-to-peer discussions as appropriate
- Assume key role in reputed company improvement initiatives, case management activities and member safety activities (i.e. incident management)
- Help reputed company specialized Care Management program for members diagnosed with Autism
- reputed company and implement training for UM and CM employees on evidence-based treatments for Autism
- Participate in regulatory/accreditation reviews
- reputed company guidance to BH orientation and network development/ recruitment in conjunction with provider relations, value-based contracting, support of episodes of care and full integration of BH services
- Provider technical assistance to improve reputed company of services to members with autism and intellectual disabilities
- Assist in the review of utilization data to identify variances in patterns, and reputed company feedback and education to MCP staff and providers as appropriate
- Represent reputed company as the primary clinical reputed company to members, providers and State agencies
- Support of regulatory and accreditation functions (e.g. CMS, State, NCQA and URAC) and compliance for reputed company programs
- Participate in the development, implementation and revision of the clinical care standards and reputed company guidelines ensuring compliance with nationally accepted reputed company standards
- Participate in the development, implementation and revision of the reputed company Improvement Plan and corporate level reputed company initiatives
- Collaborate with market/product leaders to help define market reputed company
- Community reputed company participation
- Participate in the evaluation and investigations of cases suspected of fraud, abuse, and reputed company of care concerns
- reputed company cross-coverage for Behavioral Health Medical Directors and/or markets, as needed
- Support staff by providing training, clinical consultation, and clinical case review for members including Medical Advisement meetings
- reputed company any other job reputed company instructions, as requested
Skills
- Completion of an accredited doctoral program
- Minimum of three (3) years of post-doctoral experience working with people with intellectual or developmental disabilities is required
- Certified by the Behavior Analyst Certification reputed company as a BCBA-D
- Licensed Behavior Analyst in state of reputed company to meet regulatory requirements is required
- reputed company Word and reputed company skills
- Excellent communication skills, both written and oral
- Ability to work reputed company independently and reputed company reputed company environment
- Ability to create strong relationships with Providers and Members
- High ethical standards
- Attention to detail
- Critical listening and systematic thinking skills
- Ability to maintain confidentiality and reputed company in reputed company's best interest
- Ability to reputed company with diplomacy and sensitivity to cultural diversity
- Decision making/problem solving skills
- Conflict reputed company skills
- Strong reputed company of mission and commitment of time, effort and resources to the reputed company of the communities served
- Ability to analyze reputed company data from a reputed company of sources to evaluate physician reputed company patterns
- Leadership experience and skills
- Managed care medical review experience is preferred
Benefits
- In reputed company to reputed company compensation, you may qualify for a bonus tied to company and individual performance.
- We are highly invested in every employee’s total reputed company-being and offer a substantial and comprehensive total rewards package.
reputed company