Location: Remote
Duration: 5-Month Contract with Possibility of Extension
Job Summary We are seeking a
Board Certified Behavior Analyst (BCBA) licensed in
Massachusetts to join our Behavioral Health Utilization Management team. In this role, you will review requests for
Applied Behavior Analysis (ABA) services and determine medical necessity using established clinical guidelines. You will collaborate with providers and internal clinical teams to ensure members receive appropriate, high-quality, and cost-effective behavioral health services.
Key Responsibilities- Conduct medical necessity reviews for Applied Behavior Analysis (ABA) service requests.
- Review clinical documentation and authorization requests using established medical necessity criteria.
- Determine benefit eligibility and medical necessity for ABA services.
- Collaborate with providers, Medical Directors, and Utilization Management teams to support timely care decisions.
- Maintain accurate clinical documentation and communicate review outcomes.
- Ensure compliance with regulatory, contractual, and organizational requirements.
- Meet productivity, quality, and turnaround time expectations.
- Participate in departmental meetings, workflow improvements, and ongoing training.
Required Qualifications- Active Board Certified Behavior Analyst (BCBA) certification.
- Active Massachusetts Applied Behavior Analyst (LABA) license (or Massachusetts license to practice ABA, as required).
- Strong clinical experience providing Applied Behavior Analysis (ABA) services.
- Experience working with individuals with Autism Spectrum Disorder (ASD) and other behavioral health conditions.
- Excellent clinical assessment, communication, and documentation skills.
- Ability to work independently in a fast-paced remote environment.
Preferred Qualifications- Experience in Utilization Management (UM) or Utilization Review (UR).
- Experience performing medical necessity reviews or prior authorization reviews.
- Health Plan, Managed Care, or Payer experience.
- Experience using InterQual, MCG, or other clinical review guidelines.
About US Tech Solutions:US Tech Solutions is a global staff augmentation firm providing a wide range of talent on-demand and total workforce solutions. To know more about US Tech Solutions, please visit
www.ustechsolutions.com .
US Tech Solutions is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, colour, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.
AI Statement: By applying, you acknowledge that AI-assisted tools may be used during hiring.
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