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Job Summary
THIS IS A TELECOMMUTER ROLE FOR THE NM, TX, OK, MT, IL PLAN AREAS
Masters-level Behavioral Health Professionals: Please note that you MUST be licensed to practice at the independent level for this role. The # of years of clinical experience required for this role is post licensure (# of years) at the independent level
Knowledge of ABA (Applied Behavior Analysis) as appropriate for treatment within the Autism Spectrum Diagnoses (ASD) is imperative for this position
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JOB SUMMARY:
This position is responsible for ensuring accurate and timely clinical review of behavioral health cases (Applied Behavior Analysis (ABA)) for medical necessity including assisting members on the telephone, reviewing medical records, reviewing cases which involves contract interpretation of behavioral health diagnoses, and utilizing knowledge of medical necessity criteria for all levels of behavioral health care from outpatient office visits to acute in-patient to out-patient office visits, especially of Applied Behavior Analysis (ABA) as appropriate for treatment within the Autism Spectrum Diagnoses (ASD).
JOB REQUIREMENTS:
Registered Nurse (RN) or Masters-level Behavioral Health Professional (LPC, LMFT, LCSW, LCPC, BCBA, RPsy) with current license to practice at the independent practice level in TX, OK, NM, MT and IL.
Current clinical license in state of operations and in good standings.
3 years clinical experience (post licensure at the independent practice level) in psychiatric setting or own behavioral health practice.
Verbal and written communication skills.
Analytical and decision making skills.
PC and database experience.
PREFERRED JOB REQUIREMENTS:
Utilization review experience.
3 years clinical experience in psychiatric setting or behavioral health practice providing and/or supervising ABA treatment.
* Experience in a school setting or working with individuals with ASD (Autism Spectrum Diagnoses)
#LI-Remote
Relocation assistance will not be provided for this position.
Sponsorship will not be provided for this position.
We encourage people of all backgrounds and experiences to apply.
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HCSC Employment Statement:
HCSC is committed to diversity in the workplace and to providing equal opportunity and affirmative action to employees and applicants. We are an Equal Opportunity Employment / Affirmative Action employer dedicated to workforce diversity and a drug-free and smoke-free workplace. Drug screening and background investigation are required, as allowed by law. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected veteran status.