Autism BCBA Clinical Reviewer

L.A. Care Health Plan; Los Angeles (CA); On-site; USD 77,265 - 123,625; Full time

Benefits offered by this job

Paid Time Off (PTO)

Tuition Reimbursement

Retirement Plans

Medical, Dental and Vision

Wellness Program

Job summary

L.A. Care Health Plan in Los Angeles, CA is seeking an Autism Program Specialist II ALD for a 1-year term with full benefits. The clinician will conduct clinical reviews for ASD-related ABA/BHT services, determine medical necessity, and coordinate documentation with providers and UM staff.

The role requires a Master’s in Psychology or ABA, and BCBA credentialing with at least 2 years of ABA experience. This position sits in Behavioral Health and offers robust standard benefits and growth

Qualifications

• Understand the EPSDT process and eligibility criteria.
• Proficient in reviewing progress reports and assessing treatment appropriateness.
• Excellent verbal and written communication and presentation skills.
• Proficient in Microsoft Office and computer skills.

Responsibilities

• Conduct clinical review of diagnostic evaluations and BHT treatment plans to determine medical necessity and accuracy of documentation.
• Review and approve BHT/ABA treatment plans for clinical justification and alignment with goals.
• Apply BCBA-level judgment to evaluate ABA service requests and progress notes for medical necessity.
• Ensure compliance with state and federal standards governing BHT/ABA referral, authorization, and documentation.

Skills

EPSDT process

Progress reports review

Verbal & written communication

Microsoft Office

Education

Master's Degree in Psychology or Applied Behavior Analysis

Bachelor's Degree

Job description

L.A. Care Health Plan in Los Angeles, CA is seeking an Autism Program Specialist II ALD for a 1-year term with full benefits. The clinician will conduct clinical reviews for ASD-related ABA/BHT services, determine medical necessity, and coordinate documentation with providers and UM staff.

The role requires a Master’s in Psychology or ABA, and BCBA credentialing with at least 2 years of ABA experience. This position sits in Behavioral Health and offers robust standard benefits and growth