The Clinical Manager of Autism Services will be responsible for the oversight and review of behavior analysis services offered to members with Autism Spectrum Disorders (ASD). The Clinical Manager of Autism Services performs an integral role by facilitating high quality, cost effective managed behavioral health care for members with an ASD related diagnosis. The Manager functions as part of an interdisciplinary team designed to meet the needs of the ASD population. The goal of care management is to enhance member and provider participation in the plan of care and to maximize continuous, comprehensive and coordinated care for each identified enrollee. The Clinical Manager works in the context of a Call Center and manages member and provider requests for information as well as the clinical authorization process. Remote candidates will be considered.
Duties and Responsibilities
- Maintains a comprehensive understanding of Beacon Policies and Procedures, Clinical Criteria and Benefit Plan requirements
- Evaluates clinical appropriateness of treatment using professional knowledge within Clinical Policy and Procedures and Benefit Plan requirements. Renders authorization decisions or refer for decisions of medical necessity non-authorization.
- Serves as an immediate resource to assigned care management staff to assist in problem solving as questions as issues arise
- Distributes workload and assume responsibility for scheduling and daily clinical oversight of assigned care management staff, including completing and maintaining accurate unit and individual statistical reporting requirements to meet quantitative and qualitative performance standards
- Collects, maintains and reports on individual and team performance related data. Monitors call productivity and complete phone and chart audits for quality management, completion of performance standards, on-going staff development and annual performance appraisals. Completes Performance Improvement Plan reviews and documentation when required
- Coordinates and provides training to new and existing staff as needed to support successful completion of assigned job responsibilities
- Maintains an environment that encourages open communication, teamwork and promotes complete commitment to provide excellent customer service internally and externally
- Assists in the hiring and orientation of new staff
- Assists in unit scheduling needs
- Provides support as needed to the Clinical Director
- Other duties as assigned
- Education: Minimum of a Master’s degree and current certification as a BCBA by the BACB,
- Licensures: Must have a valid BCBA or BCBA-D certification and licensure as a Licensed Behavior Analyst in those states with licensure available.
Years & Type of Relevant Work Experience
- 3-5 years of clinical experience in home based treatment providing Applied Behavioral Analysis (ABA) services to children diagnosed with ASD including supervisory experience
- Possess clinical, medical utilization review and/or quality assurance experience
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Beacon Health Strategies, LLC., a Beacon Health Options company, is proud to be an Equal Opportunity Employer as well as a Drug Free Work Environment. EOE/M/F/Veterans/Disabled