Licensed Social Worker
5 days ago
Job ID #1704415
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About this Role
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 incumbent will screen, triage and assess members to determine the appropriate level of care based on medical necessity criteria. The incumbent will review and process requests for authorization of BHT services from behavioral health providers. The incumbent is responsible for utilization management, quality reviews and monitoring activities of BHT services. The incumbent will directly interact with providers for care coordination for BHT/ABA services.
Job details
$55.46 / hour
Orange, California
New
Profession: Licensed Social Worker
Facility Type: ???
Specialty: Health Plan
Division: MedFi
Start Date: 01/13/2025
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Responsibilities
Required Qualifications
• Master's degree in psychology, social work, counseling or related field required PLUS 4 years of experience providing ABA and or mental health services, including experience in clinical review and treatment plan oversight
• Prior authorization/utilization review experience.
• Managed care experience preferred
• Quality assurance experience preferred
• 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)
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