Director of Clinical Quality, Compliance

Job not on LinkedIn

🔥 1 minute ago

Apply Now

Find Similar Remote Jobs

Set Up Email Alert For New Jobs

📊 Check your resume score for this job

Improve your chances of getting an interview by checking your resume score before you apply.

Upload Resume

Apollo Behavior

WebsiteLinkedInAll Job Openings

201 - 500 employees

⚕️ Healthcare Insurance

📚 Education

🌍 Social Impact

💰 $4.2M Venture Round on 2023-02

Healthcare Insurance • Education • Social Impact

Apollo Behavior is a leading provider of applied behavior analysis (ABA) therapy, specializing in services for children with autism. The organization focuses on a highly personalized and individualized approach, offering center-based, in-home, and telehealth treatment options. Apollo Behavior is committed to helping children reach their full potential through creative and stimulating activities facilitated by Board Certified Behavior Analysts who provide close oversight and tailored programs.

📋 Description

• Stay ahead of payer changes. Review and interpret updates to various payer manuals and translate them into clear guidance for our clinical team • Review and approve all treatment plans. Serve as the final clinical approver of treatment plans and reassessment (around 100 per month) before they are submitted to payors for prior authorization • Coach and elevate the team. Provide specific feedback to treating BCBAs and Clinical Directors that help them grow and develop as clinicals in their ability to create top tier and compliant treatment plans and other related documentation. • Drive quality and compliance. Track denials, identify trends, and recommend training, templates or workflows that reduce errors and improve outcomes. • Be a resource. Help clinicians understand the “why” behind payer requirements and best practices in ABA.

🎯 Requirements

• Master’s Degree in Applied Behavior Analysis (or equivalent) • Experience working in prior authorization review with Georgia payors • BCBA certification and licensed in Georgia • Computer Skills: Intermediate to advanced Microsoft Office, including Excel, PowerPoint, and Word. Skill with database systems preferred. Proficiency with CentralReach and the ability to use various workflow management software and comfortability with the use of AI tools to support documentation review and efficiency. • Willingness to complete and pass required background checks