Remote BCBA - Behavioral Treatment & Medicaid PA Expert

Gainwell Technologies LLC; Wisconsin; Remote; USD 91,000 - 130,000; Full time

Benefits offered by this job

401(k) employer match

Comprehensive health benefits

Flexible vacation policy

Educational assistance

Job summary

Gainwell Technologies LLC is seeking a remote clinical professional to evaluate medical necessity and eligibility under state Medicaid policies. You will collaborate with providers and internal teams as a clinical subject matter expert supporting both internal and external stakeholders.

This full-time role requires a current BCBA license in Wisconsin (or eligibility for WI licensure) and strong policy interpretation and organizational skills.

Qualifications

• Current BCBA license in the state of Wisconsin, or licensure in another state with the ability to obtain Wisconsin licensure prior to the start date.
• Ability to effectively interpret and communicate policies and procedures.
• Strong organizational skills with the ability to manage competing priorities and meet deadlines with minimal supervision.

Responsibilities

• Enter prior authorization determinations into the Medicaid Management Information System (MMIS) for processing.
• Provide education, guidance, and support to providers regarding prior authorization requirements and submissions.
• Review provider and member communications related to new or revised policies.
• Serve as a trusted clinical subject matter expert for providers, internal teams, and external stakeholders.

Skills

Policy interpretation

Organizational skills

Policy communication

Education

BCBA license (WI)

Licensure eligible (WI)

Job description

Gainwell Technologies LLC is seeking a remote clinical professional to evaluate medical necessity and eligibility under state Medicaid policies. You will collaborate with providers and internal teams as a clinical subject matter expert supporting both internal and external stakeholders.

This full-time role requires a current BCBA license in Wisconsin (or eligibility for WI licensure) and strong policy interpretation and organizational skills.