Utilization Review Clinician - ABA

Spectraforce Technologies, Inc.; Raleigh (NC); Remote; USD 65,000 - 90,000; Full time

Job summary

Spectraforce Technologies, Inc. is seeking a Utilization Review Clinician - ABA to manage a large caseload, conduct monthly outreach, and coordinate care with multidisciplinary teams.

The role emphasizes documenting activities and ensuring timely follow-up on ongoing care plans while leveraging digital care platforms and CRM systems. Required BCBA certification and Licensed Behavior Analyst credentials, plus 2–4 years of related experience.

Qualifications

• Must be a BCBA-certified professional eligible for licensure as a Behavior Analyst in the relevant state.
• Licensed Behavior Analyst credential is required for this role.
• Experience with high-volume outreach and care management is essential.

Responsibilities

• Manage 90+ member caseload and 30+ pending cases.
• Conduct monthly outreach to active members for needs assessment and care plan follow-up.
• Coordinate services, resources, referrals, and follow-up interventions to support outcomes.
• Document outreach, assessments, interventions, and progress in care management systems.
• Participate in multidisciplinary care team meetings and ABA rounds.

Skills

Caseload management

High-volume outreach

Care coordination

CRM systems

Education

BCBA certification

Licensed Behavior Analyst

Tools

CRM systems

Job description

Title: Utilization Review Clinician - ABA

Duration: 3 Months - Contract-to-Hire

Location: Remote - GA

Mon-Fri | 8A-5P EST

Position Summary:

• Manage a caseload of 73+ active members and 30+ pending cases, ensuring timely outreach, follow-up, and care coordination.
• Conduct monthly outreach to all active members at minimum once per month to assess needs, provide resources, address barriers to care, and follow up on ongoing care plans.

Key Responsibilities:

• Manage a caseload of 73+ active members and 30+ pending cases, ensuring timely outreach, follow-up, and care coordination.
• Conduct monthly outreach to all active members at minimum once per month to assess needs, provide resources, address barriers to care, and follow up on ongoing care plans.
• Support members in maintaining independent daily functioning by identifying needs, connecting members with appropriate community and healthcare resources, and monitoring progress.
• Conduct member outreach through telephone-based care management and digital care management platforms to provide ongoing support and engagement.
• Assess member needs and coordinate appropriate services, resources, referrals, and follow-up interventions to support positive health and care outcomes.
• Participate in multidisciplinary care team meetings to discuss member needs, care plans, barriers, and progress.
• Participate in and facilitate ABA rounds, contributing to case discussions, care planning, and coordination of member services.
• Maintain accurate and timely documentation of member outreach, assessments, interventions, resources provided, and follow-up activities.
• Prioritize and manage daily workload independently while balancing active caseload responsibilities, pending cases, outreach requirements, care coordination, and team meetings.
• Identify members requiring additional intervention or escalation and collaborate with appropriate care team members to address complex needs.

Candidate Requirements

Education/Certification

• Required: BCBA - Board Certified Behavior Analyst
• Preferred:

Licensure

• Required: Licensed Behavior Analyst
• Preferred:

Years of experience required: 2 - 4 years of related experience

Disqualifiers: NA

Additional qualities to look for:

Top 3 must-have hard skills stack-ranked by importance

1. Ability to manage a 90+ member caseload, identify member needs, coordinate services, and transition members into active care management.
2. Experience conducting high-volume outreach, working BH members and conditions, and engaging members in appropriate healthcare services.
3. Proficiency with healthcare case-management/CRM systems, maintaining task queues, documenting outreach, tracking member status, and managing daily productivity/conversion metrics.