Utilization Review Clinician - ABA

Location: Fully remote; preference for applicants residing in Florida. Schedule: Monday through Friday, 8:00 am to 5:00 pm Eastern Time, with occasional weekends and holidays.

Pay: $27.02–$48.55 per hour.

Company

hirify.global provides healthcare services focused on improving access to care for individuals, families, and communities.

What you will do

• Review member care and health status before, during, and after Applied Behavioral Analysis services.
• Perform behavioral health prior authorization reviews using ABA regulatory guidelines and medical necessity criteria.
• Analyze behavioral health member data to improve quality and appropriate service utilization.
• Collaborate with behavioral health providers and healthcare teams regarding levels of care and services.
• Educate members and families about ABA and the behavioral health utilization process.
• Provide leadership feedback on care improvement, process development, and policy changes.

Requirements

• Graduate of an accredited nursing school or a bachelor's degree with 2–4 years of related experience.
• For Enterprise Population Health roles, at least 2 years of experience providing ABA services as a BCBA.
• Independent professional licensure and state-required credentials are required.
• One of the following credentials is required: LCSW, LMHC, LPC, LMFT, LMHP, BCBA, RN with BCBA, or LBA where required by the state.
• A master's degree is required for behavioral health clinicians.
• Behavioral health knowledge and experience reviewing or assessing ABA treatment plans are required.

Nice to have

• Experience working with providers and healthcare teams on Applied Behavioral Analysis services.
• Independent licensure with ABA experience and BCBA certification.

Culture & Benefits

• Health insurance and comprehensive employee benefits.
• 401(k) and stock purchase plans.
• Tuition reimbursement.
• Paid time off and holidays.
• Flexible work approaches, including remote, hybrid, field, and office schedules.