Director Bcba Insurance Reviewer Jobs (NOW HIRING)

The Clinical Director is responsible for providing clinical oversight, mentorship, and support to a team of BCBAs while maintaining a reduced caseload. This role serves as the first level of clinical leadership, ensuring high quality service delivery, timely documentation, and effective problem solving across assigned cases.

1. Clinical Oversight & Quality Assurance

• Review and approve all treatment plans, reassessments, and clinical documentation prior to submission for:

  • Clinical accuracy

  • Medical necessity

  • Clear skill acquisition and behavior reduction programming

  • Alignment with assessment data and client needs

• Ensure all programs in CentralReach (CR):

  • Have clear, measurable targets

  • Include appropriate prompting, reinforcement, and generalization strategies

  • Are individualized and not templated

• Provide specific, actionable feedback on reports within expected turnaround times

• Require and verify completion of revisions prior to approval

• Identify patterns of weak clinical writing or programming and address directly with BCBA

2. BCBA Supervision & Support

• Serve as the direct clinical support for an assigned group of BCBAs

• Maintain consistent availability during business hours for clinical questions

• Conduct structured check-ins (weekly or biweekly) that include:

  • Caseload review

  • Clinical barriers

  • High-risk clients

  • Parent concerns

  • Staff performance issues

• Maintain active group communication channel (Teams/chat) to:

  • Provide real-time guidance

  • Share updates and expectations

  • Address team wide questions

• Provide direct guidance and coaching on:

  • Complex or high-risk cases (aggression, elopement, regression, etc.)

  • Behavior intervention strategies and modifications

  • Parent communication and difficult conversations

  • BT performance concerns impacting clinical care

• Support BCBAs in clinical decision making while ensuring alignment with company standards

3. Compliance & Timeliness Oversight

• Actively monitor and track for assigned BCBAs:

  • Reassessment due dates and completion status

  • Treatment plan submission timelines

  • Monthly fidelity checks completion

  • Monthly BT check-ins completion

  • Case Opening Review completion for new clients

  • First supervision session completion for new BTs/clients

  • Parent training frequency and completion

• Ensure all required components are completed within expected timeframes

• Follow up directly with BCBAs on missing or overdue items with clear deadlines

• Hold BCBAs accountable for repeated noncompliance

• Identify trends (e.g., chronic lateness, missed requirements) and:

  • Address directly with the BCBA

  • Escalate to Clinical Director when patterns persist

4. Escalation Management

• Serve as the first point of contact for escalated issues, including:

  • Clinical concerns requiring higher-level review

• Gather relevant information, assess the situation, and determine appropriate next steps

• Provide guidance or resolution when appropriate within role scope

• Escalate to Clinical Director when:

  • Issues involve high risk or liability

  • There is potential for discharge

  • Staff performance requires formal action

  • Parent concerns cannot be resolved at the Clinical Lead level

• Ensure timely follow up and documentation of all escalated concerns

5. Training, Mentorship & Clinical Development

• Support onboarding of new BCBAs by:

  • Reviewing initial cases and programming

  • Ensuring understanding of company expectations and systems

  • Providing early-stage feedback and support

• Provide ongoing mentorship to assigned BCBAs through:

  • Direct feedback on clinical work

  • Skill-building in assessment, programming, and behavior intervention

  • Support with clinical reasoning and case conceptualization

• Identify skill gaps across the team and address through:

  • Individual coaching

  • Group guidance

  • Training topics

• Participate in and/or lead clinical trainings, meetings, or case discussions

6. Collaboration & Leadership

• Attend and actively participate in leadership meetings with Clinical Director

• Provide updates on:

  • Team performance

  • Compliance status

  • High-risk clients

  • Staff concerns

  • Support needs

• Communicate proactively with Clinical Director regarding:

  • Trends impacting quality or operations

  • Staffing or caseload concerns

  • Risks to client care or service delivery

• Maintain consistency in clinical expectations and enforcement across all assigned BCBAs

• Model professionalism, accountability, and clinical excellence

Role Expectations

• Maintain strong organization and follow-through across multiple BCBAs and cases

• Balance support with accountability

• Address issues proactively rather than reactively

• Uphold clinical quality while supporting efficiency and timeliness

Qualifications

• Active BCBA certification

• At least 2 years' experience in a BCBA role

• Strong clinical and assessment skills

• Demonstrates leadership, communication, and problem-solving abilities

• Ability to manage multiple priorities and support a team effectively

Performance Expectations

• High-quality and timely review of clinical documentation

• Consistent communication and support to assigned BCBAs

• Reduction in overdue reports and compliance issues

• Positive team feedback and improved BCBA performance

Brightview Care is an Equal Opportunity Employer. We celebrate diversity and are committed to creating an inclusive environment for all employees. We do not discriminate on the basis of race, color, religion, sex (including pregnancy, gender identity, and sexual orientation), national origin, age, disability, genetic information, or any other protected status under applicable law.