Remote Behavioral Health Utilization Clinician (ABA)

The Judge Group; Mendota (MN); On-site; USD 70,000 - 90,000; Full time

Job summary

The Judge Group is seeking an experienced Behavioral Health Utilization Management Clinician to review outpatient Applied Behavior Analysis (ABA) services for medical necessity and appropriateness of care. This role requires strong clinical judgment and the ability to collaborate with providers while ensuring regulatory and contractual compliance.

The ideal candidate holds an active behavioral health license (e.g., LCSW, LPC, LMFT, RN, BCBA) and has at least 2 years of ABA-focused experience.

Qualifications

• Requires active, unrestricted behavioral health license in the State of Nevada.
• Minimum of 2 years of clinical behavioral health experience, including ABA.
• Experience with Medicaid and Commercial health plan benefits, utilization management processes, and medical necessity criteria.
• Experience reviewing behavioral health treatment plans and documentation.
• Strong written and verbal communication skills.
• Ability to work independently while collaborating in a team.
• Proficiency with clinical systems, EHRs, utilization management platforms, and MS Office.

Responsibilities

• Review outpatient ABA service requests for medical necessity using established criteria.
• Evaluate treatment plans, assessments, and supporting clinical documentation.
• Apply criteria to determine level of care and service intensity.
• Collaborate with providers to obtain information and discuss recommendations.
• Make authorization determinations and document decisions in UM system.
• Ensure compliance with federal/state health plan requirements and UM processes.
• Maintain productivity and turnaround time in a high-volume setting.

Skills

Clinical judgment

Utilization management

Provider collaboration

Documentation

EHR proficiency

MS Office

Multi-tasking

Education

MSW/MA in Social Work or related field

LCSW/LPC/LMFT or equivalent license

BCBA or Licensed Behavior Analyst (LBA)

RN licensure (optional)

Job description

The Judge Group is seeking an experienced Behavioral Health Utilization Management Clinician to review outpatient Applied Behavior Analysis (ABA) services for medical necessity and appropriateness of care. This role requires strong clinical judgment and the ability to collaborate with providers while ensuring regulatory and contractual compliance.

The ideal candidate holds an active behavioral health license (e.g., LCSW, LPC, LMFT, RN, BCBA) and has at least 2 years of ABA-focused experience.