Board-Certified Behavior Analyst

Job not on LinkedIn

🔥 7 minutes ago

🇺🇸 United States – Remote

💵 $94.1k - $164.8k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

🧐 Analyst

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

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

CareSource

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 30+ years

⚕️ Healthcare Insurance

Healthcare Insurance

CareSource is a health services company focused on providing affordable health insurance and healthcare solutions. It offers a wide range of plans including Medicaid, Marketplace, and Medicare Advantage, targeting low-income adults, families, children, pregnant women, elderly adults, and people with disabilities. Additionally, CareSource provides members with resources for COVID-19 support, dental, vision, and hearing benefits, as well as pharmacy services. The company emphasizes easy access to healthcare management through online platforms and a mobile app.

📋 Description

• Oversee coverage determinations for ABA utilization management to ensure members receive appropriate and medically necessary care in the most cost-effective setting • Conduct or assist with peer-to-peer discussions as appropriate • Assume key role in quality improvement initiatives, case management activities and member safety activities (i.e. incident management) • Help Develop specialized Care Management program for members diagnosed with Autism • Develop and implement training for UM and CM employees on evidence-based treatments for Autism • Participate in regulatory/accreditation reviews • Provide guidance to BH orientation and network development/ recruitment in conjunction with provider relations, value-based contracting, support of episodes of care and full integration of BH services • Provider technical assistance to improve quality of services to members with autism and intellectual disabilities • Assist in the review of utilization data to identify variances in patterns, and provide feedback and education to MCP staff and providers as appropriate • Represent CareSource as the primary clinical liaison to members, providers and State agencies • Support of regulatory and accreditation functions (e.g. CMS, State, NCQA and URAC) and compliance for all programs • Participate in the development, implementation and revision of the clinical care standards and practice guidelines ensuring compliance with nationally accepted quality standards • Participate in the development, implementation and revision of the Quality Improvement Plan and corporate level quality initiatives • Collaborate with market/product leaders to help define market strategy • Community collaborative participation • Participate in the evaluation and investigations of cases suspected of fraud, abuse, and quality of care concerns • Provide cross-coverage for Behavioral Health Medical Directors and/or markets, as needed • Support staff by providing training, clinical consultation, and clinical case review for members including Medical Advisement meetings • Perform any other job related instructions, as requested

🎯 Requirements

• Completion of an accredited doctoral program • Minimum of three (3) years of post-doctoral experience working with people with intellectual or developmental disabilities is required • Managed care medical review experience is preferred

🏖️ Benefits

• substantial and comprehensive total rewards package