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Care Manager - Applied Behavior Analysis (ABA)

Company: Beacon Health Options
Location: Kirkland
Posted on: October 9, 2020

Job Description:

We Help People Live their Lives to the Fullest Potential!

For more than 30 years, Beacon has changed the way people live with behavioral health conditions. Today, we are the undisputed leader in behavioral health management, serving 40 million people across all 50 states. At Beacon, we are committed to delivering a'world-class' candidate experience from the moment you click'Apply'! Our goal is to help you reach your fullest potential, while utilizing your talents and expertise to help us deliver on our promise.

Do you have a passion for helping others? If so, we are looking for you!

Beacon is currently seeking a Care Manager-Applied Behavior Analysis (ABA)a highly organized and compassionate professional to join our team in Beaverton, OR. The Care Manager- ABA authorizes and reviews utilization of ABA services while operating under a BCBA certification; assists with discharge planning and ambulatory follow up activity, provides member assistance and participates in special utilization projects. continuity of care.

What does a typical day look like?


  • Performs care review and authorization determinations for prospective, concurrent and discharge review with ABA providers as assigned
  • Determines appropriate level of care related to ABA treatment for members based on applicable medical necessity level of care criteria
  • Consults with Beacon Physician Advisors (PA) when requests for services do not appear to meet medical necessity criteria
  • Interacts with Physician Advisors to discuss clinical/authorization questions, alternative treatment options and concerns regarding specific cases
  • Provides information to members and providers regarding ABA benefits and community treatment resources
  • Provides telephone triage and crisis intervention to callers and, when necessary, assists with ensuring members have access to local services and resources
  • Ensures notification of care determination is made to provider and member
  • Identifies and refers high risk members to care management.
  • Recognizes quality of care issues and reports them appropriately through internal and external processes.
  • Interacts with providers and facilities in a professional, respectful manner
  • Complies with all Beacon policy guidelines, external regulatory requirements and URAC/NCQA accreditation standards.
  • Participates in clinical rounds
  • Assists with NCQA, URAC and other QI initiatives
  • Other duties as assigned

    What you Contribute?

    Education: Master's degree or higher in a health related field.

    • Certain specialties may require specific certification, such as Board Certified Behavior Analyst, in addition to educational requirements.

      Licensure: Board Certified Behavior Analyst (BCBA) required

      Knowledge, Skills& Abilities:

      • Minimum of two (2) years, post licensure, of combined direct behavioral health clinical and managed care experience. Contracts may dictate other specific experience and/or licensure requirements.
      • Strong problem solving, organizational and good written and verbal communication skills.
      • Outstanding interpersonal skills needed to frequently interact with members, families, providers and insurance representatives to address a variety of concerns and requests.
      • General knowledge of Microsoft Office Suite: Outlook, Excel, and Word

        Remote position must reside in Oregon or Washington State

        What Makes Us Different?

        • Here, it's not just a job- it's an opportunity to change lives.
        • Our employees are learners, innovators and original
        • Our mission and values guide the way we treat our members, providers and each other.

          What We Have to Offer:

          • Healthcare benefits available starting day 1!
          • Health& wellbeing incentives, such as gym membership reimbursement
          • 401K with company match to help reach your future financial goals
          • Generous PTO, because we know life happens outside of work
          • Tuition reimbursement so you can keep reaching your fullest potential

            If Beacon sounds like the place for you, what are you waiting for? Apply with us today to get started!

            Beacon Health Options is proud to be an Equal Opportunity and Affirmative Action Employer as well as a Drug Free and Tobacco Free Work Environment. EOE/AA/M/F/Veterans/Disabled

            At Beacon Health Options, our candidate's data privacy is a top priority. Our recruiting team conducts all communications using official company email (@BeaconHealthOptions.com). Only candidates who have applied for an open position through our Careers page (careers.beaconhealthoptions.com) will be engaged in our interview process. Beacon conducts all interviews in person or over the phone. At no time during the recruiting process will any Beacon recruiter request any financial or personally identifiable information from you.

            #LI-7CF1

            #GD

            #CB

            PM16

Keywords: Beacon Health Options, Kirkland , Care Manager - Applied Behavior Analysis (ABA), Executive , Kirkland, Washington

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