Manager, BH Utilization Management, ABA Peer Reviewer

Healthfirst

. Provide clinical leadership, supervision, and coordination of daily Behavioral Health Utilization Management and ABA activities .

Posted 10/26/2026full-timeUnited StatesMid-LevelSenior💰 $103,400 - $149,430 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in Behavioral Health Utilization Management and ABA activities, providing clinical leadership and oversight while ensuring compliance with regulations and quality standards. Proficient in performance management, strategic planning, and collaboration with multidisciplinary care teams.

Highest-signal resume keywords

Licensed Behavior Analyst (LBA)Board Certified Behavior Analyst (BCBA)Utilization Management ExperienceClinical Oversight and Peer ReviewMicrosoft Office Suite Proficiency

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Behavioral Health Utilization ManagementClinical ReviewPerformance ManagementMedical Necessity DeterminationQuality Improvement Methodologies

Soft Skills

Verbal CommunicationWritten CommunicationProblem-SolvingCoaching and FeedbackCollaboration

Tools & Technologies

Microsoft ExcelMicrosoft WordMicrosoft PowerPointMicrosoft Outlook

Certifications & Qualifications

Licensed Behavior Analyst (LBA)Board Certified Behavior Analyst (BCBA)LCSWLMSWLMHC

Industry Keywords

Utilization ManagementClinical PracticeMedicaidCommercial PlansNew York Child Health PlusIncident ManagementRegulatory ComplianceQuality Management Case Philosophies

About the role

Key responsibilities & impact

Provide clinical leadership, supervision, and coordination of daily Behavioral Health Utilization Management and ABA activities
Manage and support a team performing pre-certification, concurrent, and retrospective clinical reviews
Develop and monitor team and individual performance goals; provide coaching, feedback, performance management, and professional development
Provide clinical oversight and peer review for complex Behavioral Health UM and ABA cases
Conduct peer-to-peer discussions with treating providers as needed
Render and document medical necessity and utilization management determinations
Provide clinical consultation and collaborate with providers and multidisciplinary care teams
Contribute to strategic planning, clinical operations initiatives, special projects, programs, and process improvement
Monitor and evaluate operational and clinical performance metrics
Ensure review activities comply with policies, regulations, contractual obligations, documentation standards, and clinical standards
Perform additional duties as assigned

Requirements

What you’ll need

New York State Licensed Behavior Analyst (LBA) or LCSW, LMSW, or LMHC with a Board Certified Behavior Analyst (BCBA)
Master’s degree or higher from an ABAI-accredited or ABAI-recognized behavior analysis degree program
Work experience demonstrating verbal and written communication skills
Experience working independently in a fast-paced environment requiring problem-solving and handling multiple priorities simultaneously
Experience utilizing Microsoft Office Suite, including Excel, Word, PowerPoint, and Outlook
Previous relevant experience in utilization management and clinical practice preferred
Knowledge of Commercial, Medicaid, and New York Child Health Plus plans preferred
Knowledge of utilization management/quality management case philosophies and state and federal reporting requirements preferred
Knowledge of member satisfaction, incident management, and applicable regulations preferred
Knowledge of quality improvement methodologies preferred

Benefits

Comp & perks

Medical, dental and vision coverage
Incentive and recognition programs
Life insurance
401k contributions
Competitive compensation and benefits package