Behavior Analyst

4 weeks ago

Orange, United States Equiliem Full time
Summary:
We are seeking a highly motivated and experienced Care Manager, with Behavioral Health experience. The Care Manager is responsible for the oversight and review of Behavioral Health Treatment (BHT) including Applied Behavior Analysis (ABA) services offered to eligible members. The Care Manager will screen, triage and assess members to determine the appropriate level of care based on medical necessity criteria. The Care Manager will review and process requests for authorization of BHT services from behavioral health providers. They are also responsible for utilization management, quality reviews and monitoring activities of BHT services. The Care Manager will directly interact with providers for care coordination for BHT/ABA services.

Duties & Responsibilities:
  • Care Management Participates in a mission driven culture of high-quality performance, with a member focus on customer service, consistency, dignity and accountability.
  • Assists the team in carrying out department responsibilities and collaborates with others to support short- and long-term goals/priorities for the department.
  • Reviews requests for medical appropriateness.
  • Verifies and processes referrals using established clinical protocols to determine medical necessity.
  • Screens requests for the Medical Director‘s review, gathers pertinent medical information prior to submission to the Medical Director, follows up with the requester by communicating the Medical Director‘s decision and documents follow-ups in the utilization management system.
  • Completes required documentation for data entry into the utilization management system at the time of the telephone call or fax to include any authorization updates.
  • Reviews International Classification of Diseases (ICD-10), Current Procedural Terminology (CPT-4) and Healthcare Common Procedure Coding System (HCPCS) codes for accuracy and existence of coverage specific to the line of business.
  • Performs quality review of submitted documents and ensures the required elements are met by the established protocols, policies and procedures.
  • Mails rendered decision notifications to the provider and member, as applicable. Adheres to utilization management regulations and processing timeframes.
  • Meets productivity and quality of work standards on an ongoing basis. Identifies potential quality issues and fraud/waste/abuse and reports timely to appropriate department.
  • Stays up to date with federal, state and local regulations that pertain to the BHT benefit. Assists with case audits as assigned.
  • Completes care coordination activities as assigned.
  • Participates in a mission driven culture of high-quality performance, with a member focus on customer service, consistency, dignity and accountability.
  • Assists the team in carrying out department responsibilities and collaborates with others to support short- and long-term goals/priorities for the department.
  • Reviews requests for medical appropriateness.
  • Verifies and processes referrals using established clinical protocols to determine medical necessity.
  • Screens requests for the Medical Director‘s review, gathers pertinent medical information prior to submission to the Medical Director, follows up with the requester by communicating the Medical Director‘s decision and documents follow-ups in the utilization management system.
  • Completes required documentation for data entry into the utilization management system at the time of the telephone call or fax to include any authorization updates.
  • Reviews International Classification of Diseases (ICD-10), Current Procedural Terminology (CPT-4) and Healthcare Common Procedure Coding System (HCPCS) codes for accuracy and existence of coverage specific to the line of business.
  • Performs quality review of submitted documents and ensures the required elements are met by the established protocols, policies and procedures.
  • Mails rendered decision notifications to the provider and member, as applicable.
  • Adheres to utilization management regulations and processing timeframes.
  • Meets productivity and quality of work standards on an ongoing basis.
  • Identifies potential quality issues and fraud/waste/abuse and reports timely to appropriate department.
  • Stays up to date with federal, state and local regulations that pertain to the BHT benefit.
  • Assists with case audits as assigned.
  • Completes care coordination activities as assigned.
  • Completes other projects and duties as assigned.

Qualifications:
Minimum
  • Master‘s degree in psychology, social work, counseling or related field required.
  • 4 years of experience providing ABA and or mental health services, including experience in clinical review and treatment plan oversight.
  • An equivalent combination of education and experience sufficient to successfully perform the essential duties of the position such as those listed above may also be qualifying.
Preferred
  • Prior authorization/utilization review experience.
  • Managed care experience.
  • Post degree ABA experience.
  • Quality assurance experience.

Required Licensure / Certifications:
  • Current CA unrestricted license such as LCSW, LPCC, LMFT, RN (with BH experience), Board Certified Behavioral Analyst (BCBA) or Board-Certified Behavior Analyst - Doctoral (BCBA-D).

Knowledge & Abilities:
  • Develop rapport and establish and maintain effective working relationships with leadership and staff and external contacts at all levels and with diverse backgrounds.
  • Work independently and exercise sound judgment.
  • Communicate clearly and concisely, both orally and in writing.
  • Work a flexible schedule; available to participate in evening and weekend events.
  • Organize, be analytical, problem-solve and possess project management skills.
  • Work in a fast-paced environment and in an efficient manner.
  • Manage multiple projects and identify opportunities for internal and external collaboration.
  • Motivate and lead multi-program teams and external committees/coalitions.
  • Utilize computer and appropriate software (e.g., Microsoft Office: Word, Outlook, Excel, PowerPoint) and job specific applications/systems to produce correspondence, charts, spreadsheets, and/or other information applicable to the position assignment.

Physical Requirements (With or Without Accommodations):
  • Ability to visually read information from computer screens, forms and other printed materials and information.
  • Ability to speak (enunciate) clearly in conversation and general communication.
  • Hearing ability for verbal communication/conversation/responses via telephone, telephone systems, and face-to-face interactions.
  • Manual dexterity for typing, writing, standing and reaching, flexibility, body movement for bending, crouching, walking, kneeling and prolonged sitting.
  • Lifting and moving objects, patients and/or equipment 10 to 25 pounds

Work Environment:
  • Work is typically indoors and sedentary and is subject to schedule changes and/or variable work hours, with travel as needed.
  • There are no harmful environmental conditions present for this job.
  • The noise level in this work environment is usually moderate.

Shift: Monday - Friday; 8:00 am - 4:30 pm
Contract Length: 6 months to 1,000 hours

Equiliem Healthcare specializes in staffing clinical, non-clinical, and allied personnel. We excel in all levels, disciplines, and specialties within the healthcare spectrum. Our projects range from short to long term local and travel assignments. Equiliem has been recognized as a certified small business enterprise. In addition, we are proud that we have earned the prestigious Joint Commission accreditation for staffing firms and have been awarded Best in Staffing 4 years running by our employees and client partners.

Benefits offered to our workers include the following:
  • Medical Insurance
  • Vision & Dental insurance
  • Life Insurance
  • 401K
  • Commuter Benefits
  • Employee Discounts & Rewards
  • Payroll Payment Options

  • Applied Behavior Analyst Assistant

    1 week ago

    Orange, California, United States About Behavior Consulting Inc Full time

    Job Responsibilities:As an Applied Behavior Analyst Assistant at About Behavior Consulting, Inc., your primary responsibility will be to assist behavior analysts and case managers in implementing treatment plans for clients aged 3-17 years old. This will involve conducting home visits, providing training and support, and documenting progress.You will work...

  • Behavior Consultant

    2 weeks ago

    Orange, California, United States About Behavior Consulting Inc Full time

    About the Role:As a Behavior Consultant at About Behavior Consulting, Inc., you will have the opportunity to work with individuals aged 3-17 years old, assisting behavior analysts and case managers in implementing treatment plans. This role requires strong communication skills, as you will be working closely with clients and their families to provide support...

  • Behavior Technician

    2 days ago

    Orange, United States About Behavior Consulting Inc Part time

    Job DescriptionJob DescriptionJob Summary· Behavior Interventionist's are responsible for assisting behavior analysts and case managers to implement treatment plans which consist of behavior reduction and skill acquisition programs. The candidate will work with individuals (ranging from the ages of 3 to 17 years old) implementing treatment plans...

  • Behavior Intervention Specialist

    2 weeks ago

    Orange, California, United States About Behavior Consulting Inc Full time

    Job OverviewAbout Behavior Consulting, Inc. is a leading agency providing Applied Behavior Analysis (ABA) services to families with children aged 3-17 years old.Salary and BenefitsCompetitive hourly rates starting at $20 per hour, depending on experience and qualifications. Additionally, employees receive paid online and field training, ongoing support and...

  • Behavior Intervention Specialist

    2 weeks ago

    Orange, California, United States About Behavior Consulting Inc Full time

    Job OverviewAbout Behavior Consulting, Inc. is a leading agency providing Applied Behavior Analysis (ABA) services to families with children aged 3-17. As a Behavior Intervention Specialist, you will play a vital role in implementing treatment plans and supporting individuals with developmental disabilities.Key Responsibilities:Implement behavior reduction...

  • Applied Behavior Analyst Assistant

    1 week ago

    Orange, California, United States Autism Learning Partners Full time

    We are looking for a dedicated and compassionate individual to fill the role of Applied Behavior Analyst Assistant at Autism Learning Partners.Job Description:This position involves working directly with experienced professionals to provide evidence-based therapies to children and families in need of support.About the Role:Assist in teaching communication...

  • Board Certified Behavior Analyst BCBA

    5 hours ago

    East Orange, United States Strides ABA Full time

    Job DescriptionJob DescriptionJob Type: Part-time, Full-timePay: $75.00 - $85.00Sign on bonus: $1,000.00Benefits:Flexible scheduleProfessional development assistanceSchedule:After schoolChoose your own hoursEvenings as neededLicense/Certification:BCBA (Required)Position Located:East Orange, NJWork Location: In Person or HybridWe are seeking a dedicated and...

  • Board Certified Behavior Analyst BCBA

    2 days ago

    East Orange, United States Strides ABA Full time

    Job Type: Part-time, Full-timePay: $75.00 - $85.00Sign on bonus: $1,000.00Benefits:Flexible scheduleProfessional development assistanceSchedule:After schoolChoose your own hoursEvenings as neededLicense/Certification:BCBA (Required)Position Located:East Orange, NJWork Location: In Person or HybridWe are seeking a dedicated and compassionate Board...

  • School Board Certified Behavior Analyst

    3 weeks ago

    Orange, United States BlazerJobs Full time

    Job DescriptionJob DescriptionMinimum 1+ years Behavior Specialist experience required.Blazer Jobs is currently seeking an experienced School Board Certified Behavior Analyst (BCBA) for a full-time role within school districts in the Orange, NJ area. The ideal candidate will have experience working in educational settings and a passion for supporting...

  • Schools - Behavior Specialist

    2 months ago

    Orange, United States ProCare Therapy Full time

    Job DescriptionJob DescriptionMinimum 1+ years Behavior Specialist experience required.ProCare Therapy is currently seeking a passionate and dedicated School-Based BCBA (Board Certified Behavior Analyst) to join our team in Orange. As a BCBA, you will have the opportunity to make a profound impact on the lives of students with special needs by providing...

  • Clinical Support Professional

    1 week ago

    Orange, California, United States About Behavior Consulting Inc Full time

    Behavior Interventionist Job SummaryAbout Behavior Consulting, Inc. is seeking a dedicated and compassionate Behavior Interventionist to join our team. In this role, you will work closely with behavior analysts and case managers to provide high-quality services to individuals with developmental disabilities.Key Responsibilities:Implement behavior reduction...

  • Behavior Therapist for Applied Behavior Analysis

    2 weeks ago

    Orange, Connecticut, United States Constellation Health Services Full time

    About the RoleWe are seeking a skilled Behavior Therapist for Applied Behavior Analysis to join our team at Constellation Health Services.This rewarding position offers the opportunity to make a meaningful difference in the lives of children and families.Key Responsibilities:Develop and implement intervention strategies using direct therapy, monitoring, and...

  • Behavioral Technician

    3 days ago

    Orange, United States Maxim Healthcare Services Full time

    Salary: $23hr - $30hr Maxim Healthcare Services (Orange County ) is hiring for a Behavioral Technician to work one-on-one with children with Autism. Why Join Maxim: + Competitive Pay & Weekly Paychecks + Health, Dental, Vision, HSA and Life Insurance + Paid Time Off + 401(k) Savings Plan + Maxcares Awards Program Responsibilities: + Help children...

  • Behavioral Technician

    2 weeks ago

    Orange, United States Maxim Healthcare Services Full time

    Salary: $23hr - $30hr Maxim Healthcare Services (Orange ) is hiring for a Registered Behavioral Technician to work one-on-one with children with Autism. Why Join Maxim: + Competitive Pay & Weekly Paychecks + Health, Dental, Vision, HSA and Life Insurance + Paid Time Off + 401(k) Savings Plan + Maxcares Awards Program Responsibilities: + Help...

  • Behavioral Technician

    7 days ago

    Orange, United States Maxim Healthcare Services Full time

    Salary: $23hr - $30hr Maxim Healthcare Services (Orange ) is hiring for a Behavioral Technician to work one-on-one with children with Autism. Why Join Maxim: + Competitive Pay & Weekly Paychecks + Health, Dental, Vision, HSA and Life Insurance + Paid Time Off + 401(k) Savings Plan + Maxcares Awards Program Responsibilities: + Help children work...

  • Behavioral Health Specialist

    1 week ago

    Orange, California, United States Kinetic Personnel Group Full time

    Job OpportunityWe are seeking an experienced Care Manager to join our team at Kinetic Personnel Group in Orange County. As a public health plan government entity, we pride ourselves on being a great place to work, offering a positive work environment and opportunities for growth and development. About the JobThis position involves reviewing and processing...

  • Behavioral Technician

    4 months ago

    Orange, United States Maxim Healthcare Services Full time

    Salary: $21-$25 Maxim Healthcare Services is hiring for an Intensive Behavioral Support Provider to work one-on-one with children with developmental delays/ challenging behaviors/ Autism. -PAID TRAINING- Why Join Maxim: + Competitive Pay & Weekly Paychecks + Health, Dental, Vision, HSA and Life Insurance + Paid Time Off + 401(k) Savings...

  • Board Certified Behavior Analyst

    2 days ago

    East Orange, United States Bright achievements Full time

    Job DescriptionJob DescriptionBCBA SupervisorBright Achievements is a leading provider of in-home and center-based ABA services, and actively seeks a Board Certified Behavior Analyst (BCBA) to join our team for cases all over New Jersey.   Extremely competitive hourly rates or fulltime position.  Opportunity for career advancement and growth along with...

  • Intervention Specialist

    1 week ago

    Orange, California, United States About Behavior Consulting Inc Full time

    Job DescriptionWe are seeking a highly motivated and detail-oriented Intervention Specialist to join our team at About Behavior Consulting, Inc. As an Intervention Specialist, you will play a critical role in supporting individuals with developmental disabilities in achieving their goals.Responsibilities: Work collaboratively with behavior analysts and case...

  • Behavior Specialist Position in a Dynamic School Setting

    1 week ago

    Orange, New Jersey, United States ProCare Therapy Full time

    About the RoleProCare Therapy is actively seeking an experienced Board Certified Behavior Analyst to join their team. This dynamic position offers a unique opportunity to make a positive impact in the community by providing behavioral services to students in a K-12 setting.The ideal candidate will have a minimum of 1+ years of experience as a Behavior...