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- Rancho Cordova, CA
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Board Certified Behavioral Analyst
Apex Systems • Rancho Cordova, CA
Posted 24 days ago
Board Certified Behavioral Analyst – Part Time (24+ hours per week)
If you are interested in being considered for this role, please send an updated resume to Jessica Bush at email@example.com
Day to Day Responsibilities of this Position and Description of Project:
Under the general supervision of the Utilization Management Manager, this position works 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 and case management for our members seeking Behavioral Health Treatment (BHT).
- Review Board Certified Behavior Analyst (BCBA) Assessments submitted by providers for adherence to BACB “best practice” guidelines.
- Review requests for Functional Behavioral Assessments (FBA) submitted by providers for medical necessity of request.
- Provide peer-to-peer case consultation to BCBA and other network providers to support treatment planning and maximize member progress.
- Act as a liaison with parents and the health care community to ensure continuum of care and support for members.
- Facilitate clinical operations process to expedite linkage to care.
- Train other Blue Shield staff about Autism Services. Train network providers as appropriate.
- Collaborate with BHT Network Development to support recruitment and provider relations
- Participate in care management model and present cases, as appropriate, during clinical case conferences.
- Participate in corporate quality improvement activities as needed.
- Assist with special projects and administrative tasks as assigned.
- Responsible for timely and professional interaction with Providers and escalates recurring or critical issues, such as quality of care or access by new patients, to appropriate management in a timely fashion.
- Interprets policies and procedures and provides interpretation and clarification on benefits, eligibility, access and authorization inquiries.
- Responsible for timely and professional interaction with providers and escalates critical issues and re-occurrences to management.
- Understands and abides by all departmental policies and procedures as well as the organization’s Standards of Conduct and Corporate Compliance Program.
- Attends mandatory Corporate Compliance Program education sessions, as required for this position, including the annual mandatory Standards of Conduct class.
- Participates actively in ensuring that all federal rules and regulations are followed as they apply to this position.
- Expert knowledge of Applied Behavior Analysis and Autism Spectrum Disorder.
- At least 5 years of experience as a Certified BCBA.
- Ability to identify problems and works towards problem resolution independently, seeking guidance as needed.
- Strong Computer skills: PC-based software programs, Word, Excel, Outlook
- Strong communication skills/100% telephonic
Apex is an Equal Employment Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other characteristic protected by law. Apex will consider qualified applicants with criminal histories in a manner consistent with the requirements of applicable law. If you have visited our website in search of information on employment opportunities or to apply for a position, and you require an accommodation in using our website for a search or application, please contact our Employee Services Department at 844-463-6178