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Utilization Management Bcba Remote Jobs in Indiana

Cleo

Customer Success Manager

Indianapolis, IN · Remote

Customer Success Manager Remote - US What You Will Be Doing * Manage a portfolio of 30+ accounts ... Monitor and act on customer health indicators, including utilization scores, CSM scores, support ...

Liberty Mutual

Workers Compensation Attorney

Carmel, IN · On-site +1

Description This role is primarily remote in the state of Indiana except for required appearances ... Technology Utilization: Employ advanced e-discovery tools, case management systems, and data ...

Liberty Mutual

Workers Compensation Attorney

Carmel, IN · On-site +1

Description This role is primarily remote in the state of Indiana except for required appearances ... Technology Utilization: Employ advanced e-discovery tools, case management systems, and data ...

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Utilization Management Bcba Remote information

What are the key skills and qualifications needed to thrive in the Utilization Management Bcba Remote position, and why are they important?

Success as a Utilization Management BCBA (Board Certified Behavior Analyst) Remote requires active BCBA certification, experience in behavior analysis, and strong knowledge of insurance and healthcare utilization review processes. Familiarity with electronic medical record (EMR) systems, claims management software, and telehealth platforms is typically necessary. Exceptional attention to detail, problem-solving abilities, and strong written communication skills help candidates excel in remote collaboration and case review. These skills are critical for accurately assessing treatment plans, ensuring compliance, and supporting quality care delivery across remote settings.

What is a Utilization Management BCBA Remote job?

A Utilization Management BCBA (Board Certified Behavior Analyst) Remote job involves reviewing treatment plans, ensuring the appropriate use of applied behavior analysis (ABA) services, and making recommendations based on medical necessity and insurance guidelines. This role typically requires assessing clinical documentation, collaborating with providers, and supporting authorization decisions. Since it is remote, communication is conducted via phone, email, or virtual meetings. The goal is to ensure quality care while managing costs effectively.

What does a typical workday look like for a Utilization Management BCBA working remotely?

A typical day for a remote Utilization Management BCBA involves reviewing and evaluating treatment plans, making medical necessity determinations, and documenting decisions in compliance with health plan guidelines. You will regularly communicate with healthcare providers, clinicians, and insurance representatives via email or video conferencing to clarify details or request additional information. Collaboration with a team of fellow BCBAs and utilization management staff is common, and you may participate in case discussions or staff meetings online. This role often includes working independently, managing multiple cases at once, and ensuring all documentation meets regulatory and quality standards.

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Utilization Management Bcba Remote jobs near you
Quality Care Manager - Remote in Indiana

Quality Care Manager - Remote in Indiana

Indiana Health Centers

Indianapolis, IN • On-site, Remote

Full-time

Medical, Retirement, PTO

Posted yesterday

Job description

Job Type
Full-time
Description
Indiana Health Centers, Inc. (IHC) is a mission-driven organization providing high-quality, affordable healthcare to underserved and uninsured populations since 1977. At IHC, a Federally Qualified Health Center, we specialize in integrated care which means having access to essential services to meet the needs of patients we serve in the community. With ten healthcare centers, eight Women, Infants, and Children (WIC) nutrition program locations, a Mobile Health Unit, and in-house Pharmacy services (select locations), we offer primary medical, dental, and behavioral healthcare services to community-based patient populations throughout Indiana that are diverse in age, educational background, and income level.
IHC is now recruiting for a remote Quality Care Manager with RN or Dietician licensure in the state of Indiana. The Quality Care Manager facilitates communication between patients, their families, caregivers, providers, and other members of the healthcare team. Their focus is to offer individualized assistance to patients with complex disease states and multiple comorbidities, as well as their families and caregivers, to overcome healthcare system and community barriers and facilitate consistent and timely medical care across the continuum of care. The Quality Care Manager is an integral part of the Patient-Centered Medical Home and Patient Care Team.
IHC's robust benefits and compensation package includes:
  • Day 1 Insurance benefits eligibility
  • Employer-paid Group Life, Short-term disability, and Long-term disability coverages, and HSA employer contributions
  • 403(b) Retirement Plan matching at one year of employment
  • Generous Paid Time Off and Floating Holidays
  • Flexible Leave of Absence programs
  • Personify Health Wellness program with paid incentives for participation
  • Employee Assistance Programs with 24/7 access to therapy consultation services
  • Annual reimbursement for position-specific CMEs/CEs
  • Student Loan repayment eligibility

Quality Care Manager role responsibilities include:
Operations functions:
  • Identify high-risk patients using population health management tools (chronic conditions, ER utilization, SDOH, and referrals).
  • Link patient with resources based on SDOH assessment.
  • Provide general clinical care coordination orientation to patients and communicate the goals and objectives of the program.
  • Provide assistance for patients referred to/from providers, case managers, and from other points of entry.
  • Evaluate patients deemed high risk by risk algorithm for care management and enroll patients who elect to participate.
  • Guide patients through transitions of care from inpatient settings to home.
  • Contact patients to facilitate continuity of care and escalate issues to appropriate team members.
  • Assist patients with adherence to existing self-management goals or development of new goals (in collaboration with practice clinical staff).
  • Assist in identifying individual and/or community needs which encourage healthy lifestyles and environments (i.e., community resources, transportation assistance, exercise programs, etc.).
  • Interact with the multidisciplinary team on behalf of the patient to resolve barriers. Communicate outcomes to patient/family/caregivers.
  • Maintain timely and appropriate documentation on patient interactions in the care management system.
  • Provide disease-specific and preventive care patient education per patient need.
  • Execute effective interventions to reduce inappropriate ER visits or length of hospital to improve care and reduce costs.

Quality functions:
  • Assist in the collection and assembly of quality improvement information for the purpose of tracking and trending.
  • Participate in cross-functional team meetings aimed at improving patient outcomes or operational processes.
  • Regularly participate in care team huddles with care managers to identify priorities, tasks, and interventions.
  • Perform population management activities as assigned. Administrative functions:
  • Compile and distribute educational material based on patient need.
  • Perform follow-up activities with patients as needed after emergency department visits or inpatient discharges.
  • Assist with scheduling medical and specialty appointments. Provide reminder phone calls for appointments and/or follow-up calls post appointment.
  • Retrieve discharge summaries and copies of medical records. Other:
  • Develop and maintain excellent working knowledge of common chronic conditions and seek information as part of continuous learning.

Required skills:
  • Experience working with patients with complex chronic disease states and multiple comorbidities.
  • Demonstrated knowledge and experience with the environment and systems through which patients must navigate.
  • Demonstrated knowledge and experience in teaching/training patients.
  • Demonstrated ability to develop and employ effective customer relationships with patients and health care team.
  • Ability to assist in the facilitation and coordination of patient care plans.
  • Excellent interpersonal communication and organization skills.
  • Ability to work independently as well as on a team with a high variety of individuals.
  • Utilize efficient time management skills.
  • High degree of creativity in problem-solving.
  • Ability and patience to navigate complex systems of care. Ability to communicate comfortably with multi-ethnic populations.
  • Strong organizational skills.
  • Proficient in computer skills, including typing and use of Microsoft Word, Excel, Outlook, Access, eCW, SharePoint, Azara, etc.

Requirements
  • Valid RN or Dietician license in the state of Indiana required.
  • 2 years general experience providing patient care in community or hospital setting.
  • 1 year care management experience or experience providing health education and outreach activities.
  • Care coordinator certification preferred.

Equal Opportunity Employment Statement
We are an equal opportunity employer. All applicants will be considered for employment without attention to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran or disability status.

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