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Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in Utilization Management and Care Management for Behavioral Health, particularly in Autism Spectrum Disorder services. Proficient in coordinating care, conducting assessments, and ensuring regulatory compliance while maintaining accurate clinical documentation.
Highest-signal resume keywords
BCBA CertificationUtilization ManagementBehavioral Health CoordinationAutism Spectrum Disorder ExperienceClinical Documentation
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Utilization ManagementCare ManagementAssessment ConductingBenefit VerificationMedical Necessity ReviewsRegulatory ComplianceClinical DocumentationHealthcare NavigationTreatment PlanningPeer Review Coordination
Soft Skills
CommunicationProblem SolvingOrganizational SkillsPositive AttitudeDecision Making
Tools & Technologies
Microsoft WordMicrosoft ExcelComputer SystemsPhone SystemsWired HeadsetsDesktop Equipment
Certifications & Qualifications
BCBA Certification
Industry Keywords
Autism Spectrum DisorderBehavioral HealthHealthcare ResourcesCare CoordinationClinical StaffingAuthorization ProcessesDenial ProcessesAppeals Processes
About the role
Key responsibilities & impact- Provide utilization management and care management for behavioral health and healthcare navigation for ASD services
- Conduct assessments and engage members, families, and caregivers to identify needs and remove barriers to care
- Connect members with appropriate healthcare and community resources
- Coordinate care and communication among members, providers, health plans, behavioral health teams, and community partners
- Support effective treatment and discharge planning
- Perform ABA utilization management activities, including benefit verification and medical necessity reviews
- Coordinate peer reviews
- Educate stakeholders regarding authorization, denial, and appeals processes
- Maintain accurate clinical documentation
- Provide ongoing member and provider support
- Ensure regulatory compliance and confidentiality
- Participate in clinical staffing, professional development, and special projects
Requirements
What you’ll need- Current BCBA certification and licensure if applicable for state of residence
- Direct experience working with children with Autism Spectrum Disorder in home and/or clinic setting
- Strong computer skills, including Word and Excel
- Ability to comprehend medical policy and criteria and clearly articulate health information
- Ability to pass background checks upon hire and throughout employment, including criminal, identity, education, employment, healthcare sanctions, prohibited parties, sex offender registry, and 10-panel drug screening
- High-speed cable or fiber optic internet installed before starting, with minimum download speed of 20 Mbps, upload speed of 5 Mbps, and maximum latency of 100 milliseconds
- Ability to use computer and phone systems frequently
- Ability to remain stationary and seated for extended periods and perform repetitive motions with arms and fingers
- Ability to communicate, exchange information, interpret data, problem solve, make decisions, organize, plan, and maintain a positive and professional attitude
- Quiet home workspace with minimal background noise
- Fixed, designated workspace in the home
- Hardwired internet connection and ability to use company-issued wired headsets and desktop equipment
Benefits
Comp & perks- Annual performance-based, discretionary incentive
- Medical, dental, and vision coverage
- 401(k) with competitive employer match
- Company-paid life and disability insurance
- Paid parental leave and wellbeing incentives
- Generous paid time off, including volunteer time
- Flexible spending accounts for healthcare and dependent care
- Professional development opportunities and tuition reimbursement
- Remote work flexibility (role-dependent)
- Meaningful personal and professional growth opportunities
- Company-provided equipment