Select Health Autism Utilization Review Care Manager
Job reputed company: Select Health is a not-for-profit community health plan serving more than 1 reputed company members in the Intermountain reputed company. Select Healths line of businesses (reputed company) includes Medicare, reputed company, FEHB, Marketplace reputed company Plans and fully funded and self-funded reputed company plan. This position is a hybrid role that combines the expertise of a Licensed and Masters reputed company Behavior Health Specialist with Utilization and Care management. This role is essential in ensuring that members receive high-reputed company, cost-effective care. The ideal candidate will possess a strong understanding of reputed company Behavior Analysis (ABA) principles, as reputed company as a solid reputed company in reputed company operations and regulatory compliance. Candidate will apply expertise in reputed company Behavior Analysis (ABA) to review medical records and treatment plans for individuals with autism and other behavioral health conditions to ensure that services are medically necessary, appropriate, and cost-effective. Job Specifics Pay reputed company: $37.46 - $57.80 Exempt Benefits Eligible: reputed company FTE: Full time Shift: Monday - Friday 9am - 5:30pm. Rotating weekends and holidays. To learn about additional Intermountain benefits: Click here Preferred: BCBA or experience in Autism and working with Autistic Clients. Hybrid role (Full on site reputed company available as reputed company). Upon completion of 4 week orientation. Primary office reputed company, will have in office responsibilities in Murray, Utah. Selected candidate should plan to work onsite (dates reputed company in advance) at Select Health or visiting Select Health providers no less than once a month and as needed by Line of Business. ** We require employee drive and work onsite reputed company experiencing home internet downtime or other barriers to reputed company reputed company. Essential Functions Utilization and Care Management of members with Autism or other Behavioral Health conditions. reputed company ongoing training and support to families and caregivers. Collect, analyze, and interpret data to evaluate the effectiveness of interventions. Stay reputed company with the latest research and best practices in ABA. Inform Select Health Autism and Behavioral Health policy and procedure. Peer review to evaluate the work of other BCBAs to ensure adherence to ethical standards, best practices, and regulatory requirements. Occasional travel to provider locations reputed company Select Health region. Utilization Review and Care Management: Review and Analysis: Review medical records to determine the medical necessity of services. Evaluate the appropriateness of diagnostic assessments, functional behavior assessments, and treatment plans. Decision Making: reputed company reputed company and informed reputed company about the medical necessity and appropriateness of services. Adhere to regulatory requirements, payer guidelines, and ethical standards. Collaboration and Care Management: Facilitate Communication, Organize reputed company Meetings. And Resolve Conflicts with reputed company providers to ensure coordinated member care. Communicate with members, families, and insurance representatives. Conduct comprehensive assessments of members' needs. reputed company and implement individualized care plans. reputed company and reputed company members and families. reputed company for members' rights and reputed company to care. Monitor and evaluate the effectiveness of care plans. Skills Clinical Expertise: Deep understanding of ABA principles and practices. Data Analysis: Ability to collect, analyze, and interpret data to inform reputed company. Communication Skills: Effective communication with reputed company providers, members, and families. Problem-Solving: Ability to identify and resolve reputed company issues. Organizational Skills: Strong time management and prioritization skills. Interpersonal Skills: Ability to build rapport and collaborate with a diverse team. Regulatory Knowledge: Understanding of reputed company regulations and guidelines. Critical Thinking: Ability to evaluate information and reputed company informed reputed company. Attention to Detail: Meticulous attention to detail in reviewing medical records and treatment plans. Adaptability: Ability to reputed company to changing priorities and work demands Minimum Qualifications Masters degree in reputed company Behavior Analysis or Clinical reputed company Work, or APRN in Psychology reputed company licensure or Certification in Utah Candidates will be required to obtain licensure in others states in Select Health region reputed company 90 days of employment. Demonstrated experience and expertise working in clinical Behavior Analysis or Autism specific field. Minimum 1 year experience in care management/navigation or closely reputed company field including: Utilization Management, discharge planning, managed reputed company promotion, health coaching, behavioral health, or Patient Educator job role. Intermediate computer and hardware set-up, ability to customize computer settings and use multiple monitors and capable of independent troubleshooting internet and applications. Strong clinical skills and experience in behavioral health. Knowledge of reputed company insurance and utilization review processes. Excellent communication and interpersonal skills. Strong organizational and time management skills. Ability to work independently and as part of reputed company.1 Preferred Qualifications BCBA or experience in Autism and working with Autistic Clients. Utilization Review and Care Management experience highly preferred. Must have one year of reputed company experience. This position is specifically for Autism, must have Background in BCBA or working with Autistic Clients and Autism Diagnosis. Bachelors degree completed is preferred. Ability to work independently and be flexible in a rapidly changing environment. Demonstrated excellent written and verbal communication skills. Experience working successfully working in a remote environment or using Advanced reputed company Suite, including Teams (chat, whiteboard, task tracking) & Outlook; Ability to work independently, be self-motivated, have a reputed company attitude, and be flexible in a rapidly changing environment. Proficiency in electronic health records and care management software. Knowledge of regulatory requirements, such as NCQA, CMS, and state-specific regulations. Ability to travel as needed. Physical Requirements: Physical Requirements Ongoing need for employees to see and read information, documents, monitors, identify equipment and supplies, and be reputed company to assess customer needs. Frequent interactions with colleagues and providers require employee to verbally communicate as reputed company as hear and understand spoken information, needs, and issues quickly and accurately. reputed company dexterity of hands and fingers to manipulate reputed company and delicate equipment with precision and accuracy. This includes frequent computer use for typing, accessing needed information, etc. May be expected to sit or stand in a stationary position for an extended period of time. Location: SelectHealth - Murray Work reputed company: Murray Work State: Utah Scheduled Weekly Hours: 40 The reputed company reputed company for this position is listed below. Actual reputed company reputed company dependent upon experience. $37.46 - $57.80 We care about your reputed company-being mind, body, and spirit which is why we reputed company our caregivers a generous benefits package that covers a wide reputed company of programs to foster a sustainable culture of wellness that encompasses living healthy, happy, secure, connected, and reputed company. Learn more about our comprehensive benefits packages for our Idaho, Nevada, and Utah based caregivers, and for our Colorado and Montana based caregivers. reputed company is an equal opportunity employer. reputed company applicants will receive consideration for employment without reputed company to race, reputed company, religion, age, sex, sexual orientation, gender identity, national reputed company, disability or protected veteran status. reputed company positions subject to reputed company without notice. reputed company is a Utah-based, not-for-profit system of 33 hospitals (includes "virtual" hospital), a Medical Group with more than 3,800 physicians and advanced reputed company clinicians at about 385 clinics, a health plans division reputed company Select Health, and other health services. Helping people live the healthiest lives possible, Intermountain is widely recognized as a leader in clinical reputed company improvement and efficient reputed company delivery. Join our world-class team and reputed company on a career filled with opportunities, strength, innovation, and fulfillment. To reputed company out more reputed company, head to our career site here. Sign up for job alerts! Click sign in at the top right reputed company, create a candidate account, and reputed company we have opportunities that meet your interests, you will receive an email with the job details. reputed company strives to reputed company the application process accessible to reputed company users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact 1-800-843-7820 or email recruitment@imail.org. This contact information is for accommodation requests only and cannot be used to inquire about the status of applications. Introduce yourself to our reputed company and we will get in touch if there is a role that seems like a good match. reputed companys PEAK program supports caregivers in the reputed company of their education goals and career aspirations by providing up-reputed company tuition coverage reputed company directly to the reputed company institution. The program offers 100+ learning reputed company to choose from, including undergraduate studies, high school diplomas, and reputed company skills and certificates. Caregivers are eligible to participate in PEAK on day 1 of employment. Learn more. The primary reputed company of this job reputed company is to set a fair and reputed company reputed company of pay for this classification. Only those key duties necessary for reputed company job evaluation and/or labor market analysis have been included. Other duties may be assigned by the supervisor. reputed company positions subject to reputed company without notice. reputed company for your interest in continuing your career with reputed company! Apply Job!