ABA Licensed Clinician in US-Remote
- Title: ABA Licensed Clinician
- Code: RCI-83413
- Location: US-Remote
- Posted Date: 11/09/2022
- Name:Dalpat Prajapati
- Email: firstname.lastname@example.org
- Phone: 908-704-8843 ✖ 412
Permanent position and 100% REMOTE
MetroPlusHealth provides the highest quality healthcare services to residents of Bronx, Brooklyn, Manhattan, Queens and Staten Island through a comprehensive list of products, including, but not limited to, New York State Medicaid Managed Care, Medicare, Child Health Plus, Exchange, Partnership in Care, MetroPlus Gold, Essential Plan, etc. As a wholly-owned subsidiary of NYC Health + Hospitals, the largest public health system in the United States, MetroPlusHealth network includes over 27,000 primary care providers, specialists and participating clinics. For more than 30 years, MetroPlusHealth has been committed to building strong relationships with its members and providers to enable New Yorkers to live their healthiest life.
Under the supervision of the Director of Clinical Case Management, the ABA Licensed 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, care coordination, consulting with providers and families to make sure members are afforded optimum care and services.
- Review of ABA diagnostic assessments and determines eligibility for ABA services
- Communicates directly with providers and/or reviews and analyzes member medical records for medical necessity determination and appropriateness of care (retrospective, concurrent, and prospective review of services).
- Determining network and/or clinical exception for out of network approval and authorizations.
- Identifying ways to add value to treatment plans and consulting with facility staff or outpatient care providers.
- Consulting with medical, nursing, and other staff involved in treatment to clarify concerns and facilitate necessary referrals.
- Monitoring treatment to members in all areas identified through ABA Plans.
- Maintaining a professional working relationship with families and providers including how to implement instructional strategies.
- Conduct care management assessments, develop service plans and coordinate any need treatment or service referrals.
- Demonstrate adequate knowledge and understanding of basic ABA principles and guidelines.
- Demonstrate flexibility in working with a variety of members with different needs and abilities.
- Communicate effectively with a variety of staff members including Medical Directors, Clinical Directors, and administrative staff.
- Identifies and communicates timely to Director of Case Management all potential quality of care concerns
- Collects all pertinent clinical information and documents within CareConnect and DCMS system
- 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, Quality Management and interventions related to improving provider quality of care and outcomes.
- 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 provider outcome and quality activities.
- 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.
- Master’s degree or higher.
- 5+ years of demonstrated experience in child behavioral health and/or ABA environment.
- Managed Care Experience preferred.
- Bi-lingual preferred.
- Experience working with children/adolescents with autism required
- Computer literacy in a Windows environment, including MS Word, Excel
- Demonstrated telephonic / office-based / field experience
Licensure and/or Certification Required:
- Requires current and valid licensure in New York as a Licensed Behavior Analyst (LBA).
- Integrity and Trust
- Leadership and Management Skills
- Customer Focus
- Functional / Technical skills
- Data Analytic skills
- Written/ Oral Communication
- Ability to successfully multi-task while under a strict timetable
- Exceptional Organizational skills
Rangam Consultants is a minority, women-owned, disability workforce solutions global organization. Specialized in attracting and retaining talents globally for a rewarding career in IT, Engineering, Scientific, Clinical, Healthcare, Administrative, Finance, Business Management, and many more, while integrating veterans and individuals with disabilities into the workforce. Indeed, we connect career aspirants to relevant job opportunities, be it jobs in USA, UK, India, or Ireland. Also remote jobs, work-from-home jobs, or contract jobs in different verticals and industries. Rangam strives to put job seekers first, giving them free access to search for jobs, post resumes, and research companies.Every day, we connect millions of people to new opportunities. p >