Board Certified Behavioral Analyst - Doctoral

Location: Columbia

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** Summary
* * Oversees and manages utilization review and care coordination for members with autism spectrum disorder (ASD) and related behavioral health conditions. This role ensures that services are medically necessary, evidence-based, and aligned with regulatory and accreditation standards. The specialist serves as a subject matter expert (SME) in autism care, supporting clinical decision-making, provider engagement, and quality improvement initiatives.#
** Description
* *** Position

Purpose:

** Oversees and manages utilization review and care coordination for members with autism spectrum disorder (ASD) and related behavioral health conditions. This role ensures that services are medically necessary, evidence-based, and aligned with regulatory and accreditation standards. The specialist serves as a subject matter expert (SME) in autism care, supporting clinical decision-making, provider engagement, and quality improvement initiatives.
*
* Location:

** This position is full-time (40-hours/week) Monday-Friday in a typical office environment, with the opportunity for hybrid work. This role is located at 4101 Percival Road, Columbia, SC 29229% Responsible for clinical reviews for ABA therapy and other autism-related services. Provides leadership and support to ensure timely and accurate determinations in compliance with CMS, NCQA, URAC and/or state guidelines. Interact with the Medical Director, or designee, to discuss clinical authorization questions and concerns regarding specific cases.
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* What You’ll Do:

*** Interact with network practitioners to provide education on best practice models and utilization management processes. Supports provider relations in resolving clinical disputes and appeals. Participates in provider training and quality improvement initiatives related to autism care.
* Provides oversight and leadership in the development and refinement of clinical policies and workflows. Provides leadership to clinical teams related to the review and operation of the management of autism spectrum disorder and related behavioral health conditions.
* Supports audit readiness and documentation standards for internal and external reviews. Respond to state, provider, and member complaints related to psychological testing or other services requiring review by a PhD/PsyD. Serves as a subject-matter expert supporting SIU investigations.
* Collaborates with case management and care coordination teams to support members with complex needs. Participates in interdisciplinary case rounds and care planning for high-risk members.
** To Qualify For This Position, You'll Need The Following:**
* ** Required

Education:

** PhD or PsyD in Clinical/Counseling Psychology or National Board Certified Behavior Analysis-Doctoral (BCBA-D).
* ** Required

Work Experience:

** 5 years Behavioral Health experience. 3 years of practical experience in autism spectrum disorder treatment and/or applied behavioral analysis (may be concurrent).
* ** Required

Skills and Abilities:

** Extensive knowledge of behavior analysis principles and techniques. Strong analytical and problem-solving skills. Proficiency in developing, implementing and reviewing behavior intervention plans to determine progress towards goals. Effective written and verbal communication skills. Ability to effectively collaborate with interdisciplinary teams as well as internal and external customers. Ability to work independently and as part of team. Ability to effectively manage a multidisciplinary team.

Track and analyze data and modify/create new programs accordingly.
* ** Required Software and Tools:
** Microsoft Office.
* ** Required Licenses and Certificates:
** Active, unrestricted PSY - Psychologist License (PhD or PsyD) in state of hire or Board Certified Behavior Analyst – Doctoral (BCBA-D).
** Our Comprehensive Benefits Package Includes The Following:
** We offer our employees great benefits and rewards. You will be eligible to participate in the benefits the first of the month following 28 days of employment.
* Subsidized health plans, dental and vision coverage
* 401k retirement savings plan with…