Behavioral Health Consultant

Working remotely as a Wisconsin Licensed Behavioral Consultant, the full-time Prior Authorization Behavioral Treatment Consultant will review and adjudicate Medicaid prior authorization requests for behavioral treatment services, ensuring timely access to care while collaborating with providers and stakeholders. Key responsibilities

Evaluate medical necessity and eligibility of prior authorization requests in accordance with state Medicaid policies Review submissions and obtain additional information from providers as needed Serve as a clinical subject matter expert, providing education and support regarding prior authorization requirements

Required qualifications

Minimum of 5 years of Behavioral Treatment experience Current BCBA license in Wisconsin or ability to obtain it before the start date Knowledge of the Wisconsin Medicaid program or other state Medicaid programs Experience collaborating with cross-functional teams and stakeholders