Behavioral Treatment Consultant

This is a fully remote position, open to applicants in Minnesota, +1 more state.

📋 Description

• Assess and decide on Medicaid prior authorization requests for behavioral treatment services.

• Analyze requests for medical necessity and eligibility in accordance with state policy guidelines.

• Review prior authorization applications and gather further information or clarification from providers.

• Input prior authorization decisions into the Medicaid Management Information System (MMIS).

• Offer education, guidance, and support to providers concerning prior authorization requirements and submissions.

• Examine communications from providers and members regarding new or updated policies.

• Act as a clinical subject matter expert for providers, internal teams, and external stakeholders.

• Promote efficient, accurate, and compliant authorization workflows.

⛳️ Requirements

• At least 5 years of experience in Behavioral Treatment.

• A current BCBA license in Wisconsin, or licensure in another state with the capability to obtain Wisconsin licensure before the start date.

• Exceptional interpersonal, verbal, and written communication abilities.

• Proficient in interpreting and conveying policies and procedures effectively.

• Strong organizational skills with the ability to handle competing priorities and meet deadlines with minimal oversight.

• Experience in collaborating with cross-functional teams and stakeholders.

• Familiarity with and/or experience working with the Wisconsin Medicaid program or other state Medicaid programs.

• Willingness to work weekends as necessary.

🏝️ Benefits

• Flexible working hours.

• Work-life balance.

• Opportunities for continuous learning and career advancement.

• Flexible vacation policy.

• 401(k) employer matching.

• Comprehensive health benefits.

• Educational assistance.

• Leadership and technical development academies.

• Flexible work options.