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ABA Certified Clinician

Department: Behavioral Health HARP

Supervisor: COREBH Clinical Director

Position Overview:

Under the supervision of the CORE BH clinical Director, the ABA UM/ CM Clinician will provide supervision of Applied Behavioral Analysis (ABA) for children with autism. In this role, you will be responsible for reviewing individualized comprehensive behavior assessments, treatment plans, conduct authorization reviews, coordinating benefits, consulting with providers and families to make sure members are afforded optimum care and services.

Scope of Role & Responsibilities:

• Analyzing and reviewing member medical records holistically (retrospective, concurrent, and prospective review of services) for medical necessity determination and appropriateness of care.

• Performing utilization review for outpatient services from Par and Non -Par providers.

• Consulting with medical, nursing, and other staff involved in treatment to clarify concerns and secure documentation, as required.

• Determining if additional clinical treatment sessions are needed.

• Managing outpatient mental health cases throughout the entire treatment plan.

• Administering benefits and reviewing treatment plans.

• Monitoring treatment to clients aged 2-21 years in all areas identified through ABA Plans.

• Maintaining a professional working relationship with families and providers including how to implement instructional strategies.

• Coordinating benefits and transitions between various areas of care to ensure an integrated approach to care including behavioral and physical medicine.

• Identifying ways to add value to treatment plans and consulting with facility staff or outpatient care providers.

• Demonstrate adequate knowledge and understanding of basic ABA principles and guidelines.

• Demonstrate flexibility in working with a variety of clients with different needs and abilities.

• Communicate effectively with a variety of staff members including Medical Directors, Clinical Directors, and administrative staff.

• Work collaboratively with each member’s team; effectively request and communicate any areas needing clarification.

• Maintains appropriate files and other clerical records, to ensure timely review and processing of records. Prepares special Utilization Management reports, as required.

• Participates in Utilization Review Management and Quality Management.

• Keeps informed of changes in regulations, procedures, and treatment standards prescribed by the provider, regulatory, and/or reimbursement agencies.

• Participates in designing quantitative measures and procedures by which program efficiency and cost-effectiveness can be audited and participates in the evaluation audits.

• Participates in internal/external quality assurance/performance improvement (QA/PI) activities and programs, facility-wide training, staff meetings, and relevant health care events, as required.

• Ensures ongoing compliance and maintenance of the NYC Health + Hospitals policies with national standards and other applicable external regulatory requirements and guidelines.

• Performs other related duties, as directed.

Required Education, Training & Professional Experience:

• An active Board-Certified Behavioral Analyst (BCBA) is required.

• PH.D is Psychology or Social Work required.

• 7+ years of demonstrated experience in a Behavioral health environment.

• Managed Care Experience preferred.

• Bi-lingual preferred.

• Experience working with children/adolescents with autism preferred

• Computer literacy in a Windows environment, including MS Word, Excel

• Demonstrated telephonic / office-based / field experience

Licensure and/or Certification Required:

• Requires valid and current license to practice in the state of New York.

• An active Board-Certified Behavioral Analyst (BCBA) is required.

• LCSW license required for social work. preferred.

Professional Competencies:

• Integrity and Trust

• Leadership and Management Skills

• Customer Focus

• Functional / Technical skills

• Written/ Oral Communication

• Ability to successfully multi-task while under a strict timetable

• Exceptional Organizational skills

Apply here:

Required Education, Training & Professional Experience: