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Bcba Autism Utilization Review Jobs (NOW HIRING)

Nationwide Children's Hospital

Conducts utilization reviews of behavioral health cases to determine medical necessity, appropriateness of care, and adherence to clinical guidelines. * Communicates with healthcare teams and third ...

UHS

DIR - UTILIZATION REVIEW / MGMT

Oakland Park, FL · On-site

... Autism, intellectual disabilities, or other neurodevelopmental disabilities. EEO Statement All UHS ... Utilization Review position, such as: * Challenging and rewarding work environment * Competitive ...

Atlas Autism Health

Autism Specialist

Lenexa, KS · On-site

$50K - $65K/yr

Whether you're preparing to sit for the BCBA exam or seeking an opportunity to expand your clinical ... Collect, review, and analyze client data to help guide clinical decision-making and monitor ...

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$47.5K

$89.1K

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How much do bcba autism utilization review jobs pay per year?

As of Aug 10, 2026, the average yearly pay for bcba autism utilization review in the United States is $89,075.00, according to ZipRecruiter salary data. Most workers in this role earn between $74,000.00 and $90,500.00 per year, depending on experience, location, and employer.

What is a BCBA Autism Utilization Review?

A BCBA Autism Utilization Review job involves evaluating applied behavior analysis (ABA) therapy services to ensure they meet clinical and insurance guidelines. Professionals in this role review treatment plans, assess medical necessity, and collaborate with providers to ensure appropriate care for individuals with autism. They may also work with insurance companies to approve or deny treatment authorizations. This position requires strong analytical skills, knowledge of ABA principles, and experience with insurance policies.

What are the typical day-to-day responsibilities for someone in a BCBA Autism Utilization Review position?

In a BCBA Autism Utilization Review role, your daily responsibilities often include reviewing treatment plans, assessing the medical necessity of services, ensuring that care meets both clinical guidelines and insurance requirements, and providing feedback or recommendations to clinical teams. You may collaborate with therapists, case managers, and insurance representatives to facilitate efficient and quality care. Additional tasks may involve documentation, attending team meetings, and staying updated on best practices and regulations in autism treatment. This position offers a blend of independent review work and interdepartmental collaboration, supporting both client progress and organizational standards.

What are the key skills and qualifications needed to thrive in the BCBA Autism Utilization Review position, and why are they important?

To excel as a BCBA Autism Utilization Review specialist, you need a solid background in applied behavior analysis, BCBA certification, and expertise in reviewing clinical treatment plans for individuals with autism spectrum disorder. Familiarity with electronic medical records (EMR) systems, utilization management software, and compliance standards is essential. Strong attention to detail, critical thinking, and effective written and verbal communication skills are key soft skills for excelling in this role. These abilities ensure precise and timely evaluations that support both quality care delivery and organizational compliance.

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What are the most commonly searched types of Bcba Autism Utilization Review jobs? The most popular types of Bcba Autism Utilization Review jobs are:
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Bcba Autism Utilization Review jobs near you
Infographic showing various Bcba Autism Utilization Review job openings in the United States as of August 2026, with employment types broken down into 36% Full Time, and 64% Part Time. Highlights an 100% In-person job distribution, with an average salary of $89,075 per year, or $42.8 per hour.

Utilization Review Specialist - Autism

Nationwide Children's Hospital

Hybrid

Full-time

Posted 19 days ago

Nationwide Children's Hospital rating

6.9

Company rating: 6.9 out of 10

Based on 131 frontline employees who took The Breakroom Quiz

551st of 1,055 rated hospitals

Job description

Overview:


Schedule: Monday-Friday (8:00am-4:30pm)

Position is work from home after a 90 day in-office training period.


Job Description Summary:


Reviews behavioral health cases to determine medical necessity and appropriateness of care, ensuring compliance with established guidelines and policies. Performs pre-certifications, pre-authorizations, re-authorization, concurrent utilization reviews, retrospective reviews, and denial management. Interacts with staff and departments of the hospital to facilitate appropriate, cost-effective patient care.


Job Description:


Essential Functions:

  • Conducts utilization reviews of behavioral health cases to determine medical necessity, appropriateness of care, and adherence to clinical guidelines.
  • Communicates with healthcare teams and third-party payors to ensure the delivery of quality care and optimum payment.
  • Assists with retrospective reviews and denial management to maintain appropriate and cost-effective patient care.
  • Documents all case reviews and maintains accurate records of all clinical activities and coverage information.
  • Provides education and support regarding utilization review and management activities and processes.
  • Analyzes clinical data to identify trends and patterns that may impact patient care. Participates in quality improvement initiatives to enhance the overall delivery of behavioral health services.
  • Facilitates reimbursement by communicating with payers, other staff, patients, and families concerning status of funding and required actions.


Education Requirement:

Bachelor's Degree in Social Work, Psychology, or related field, required.


Licensure Requirement:

(not specified)


Certifications:

(not specified)


Skills:

  • Excellent written and verbal communication and interpersonal skills.
  • Excellent customer service and organizational skills.
  • Working knowledge of CMS and other review agency standards.
  • Proficient with software applications including CM, payer web applications, MITS, and others.


Experience:

  • Three years of behavioral health experience, required.
  • One year of experience in pediatric care or services, required.
  • Utilization review or utilization management experience, preferred.


Physical Requirements:

OCCASIONALLY: Bend/twist, Climb stairs/ladder, Flexing/extending of neck, Lifting / Carrying: 0-10 lbs, Reaching above shoulder, Squat/kneel

FREQUENTLY: Standing, Walking

CONTINUOUSLY: Audible speech, Color vision, Computer skills, Decision Making, Depth perception, Hand use: grasping, gripping, turning, Hearing acuity, Interpreting Data, Peripheral vision, Problem solving, Repetitive hand/arm use, Seeing - Far/near, Sitting


Additional Physical Requirements performed but not listed above:

(not specified)




"The above list of duties is intended to describe the general nature and level of work performed by individuals assigned to this classification. It is not to be construed as an exhaustive list of duties performed by the individuals so classified, nor is it intended to limit or modify the right of any supervisor to assign, direct, and control the work of employees under their supervision. EOE M/F/Disability/Vet"

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About Nationwide Children's Hospital

Sourced by ZipRecruiter

Nationwide Children's Hospital, established in 1894, is a leading pediatric healthcare system based in Columbus, Ohio, United States. They serve as a primary pediatric network, providing wellness, preventive, diagnostic, treatment, and rehabilitative care for infants, children, adolescents, and adults with congenital disease. Being the third-largest pediatric hospital in the nation, Nationwide Children's Hospital prides itself on its relentless commitment to children and their families, driven by their core values of respect, integrity, determination, empathy, and solidarity. The institution's comprehensive mission is to enhance the health of children by providing high-quality, family-centered care, conducting groundbreaking research, advocating for pediatric health, and training top healthcare professionals.

Industry

Hospitals

Company size

10,000+ Employees

Headquarters location

Columbus, OH, US

Year founded

1892

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