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Overnight 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 ...

CareConnect

Utilization Review RN

Greenvale, NY · On-site

Reviews and coordinates prospective, concurrent and retrospective activities related to utilization ... Responds to outstanding utilization management issues and inquiries made via overnight voicemail ...

CareConnect

Utilization Review RN

Greenvale, NY

Reviews and coordinates prospective, concurrent and retrospective activities related to utilization ... Responds to outstanding utilization management issues and inquiries made via overnight voicemail ...

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Overnight Bcba Autism Utilization Review information

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

As of Aug 11, 2026, the average yearly pay for overnight 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 the difference between Overnight Bcba Autism Utilization Review vs Bcba Autism Case Manager?

AspectOvernight Bcba Autism Utilization ReviewBcba Autism Case Manager
CredentialsBCBA certification, relevant experienceBCBA certification, case management experience
Work EnvironmentHealthcare facilities, insurance review settingsCommunity clinics, home-based settings
Employer & IndustryInsurance companies, healthcare providersBehavioral health agencies, schools
Primary FocusReviewing autism treatment utilization overnightManaging autism treatment plans and client progress

The Overnight Bcba Autism Utilization Review primarily involves evaluating autism treatment utilization during overnight periods, focusing on insurance and healthcare review processes. In contrast, the Bcba Autism Case Manager actively manages treatment plans and supports clients' progress. Both roles require BCBA certification but differ in daily responsibilities and work environments.

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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 1,056 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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