Behavior Analyst - ABA & Medicaid Review Specialist

Alliant Health Group; Tennessee; On-site; USD 60,000 - 90,000; Full time

Job summary

Alliant Health Group seeks a BCBA-certified Behavior Analyst to join a multidisciplinary team and oversee ABA service reviews, function analyses, assessments, and adaptive life skills. The role includes prior authorization reviews for Georgia Medicaid members and out-of-state requests, with consultative support for contract development.

The position requires collaboration across Alliant Health Group contracts, coordination of out-of-state treatment reviews, and education of providers on review

Qualifications

• Master's degree and BCBA certification required.
• 3–5 years' experience in intellectual disabilities or related disabilities.
• Strong analytical and documentation skills.
• Experience with Medicaid review processes is a plus.

Responsibilities

• Ensures required review documentation is complete and current; maintains organized electronic records for each applicant.
• Performs assessment and review of ABA services, function analyses, and adaptive life skills.
• Makes accurate decisions based on DCH Policy Manual and documents rationale within contract time frames.
• Data entry of clinical reviews and decisions into the Prior Authorization system; refers cases per policy.
• Prepares determination letters and responds to provider inquiries within established time frames.
• Collaborates with ABA SME across Alliant Health Group contracts and coordinates out-of-state treatment reviews.
• Liaises with providers and DCH, educates providers on review processes, and monitors treatment plans.

Skills

BCBA certification

Communication skills

Analytical thinking

Travel willingness

Education

Master's degree

Tools

Microsoft Office (Word & Excel)

Job description

Alliant Health Group seeks a BCBA-certified Behavior Analyst to join a multidisciplinary team and oversee ABA service reviews, function analyses, assessments, and adaptive life skills. The role includes prior authorization reviews for Georgia Medicaid members and out-of-state requests, with consultative support for contract development.

The position requires collaboration across Alliant Health Group contracts, coordination of out-of-state treatment reviews, and education of providers on review