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Clinical Quality Reviewer - BCBA

Onos Health

Clinical Quality Reviewer - BCBAOnos Health's mission is simple but ambitious: ensure every healthcare dollar goes toward delivering the highest quality care. Today, nearly 30% of U.S. healthcare spending is wasted due to ineffective care and administrative burden, driven by misalignment between providers and payers. This waste is a primary reason healthcare remains unaffordable for so many.Onos is addressing this by building the largest AI-driven healthcare data platform for clinical decision-making. Onos' models help health plans make faster, more accurate decisions across their populations. The result is less friction between plans, providers, and members, better outcomes, and more affordable care.The role:At Onos, we partner with payers to help improve outcomes, ensure high quality of care for every member and reduce provider friction. We are seeking a Board Certified Behavior Analyst (BCBA) with deep clinical expertise to support in solving these needs and refining our models and product. This role offers the opportunity to help shape innovative technology solutions designed to improve quality specifically in autism/ABA services.In this role, you'll report directly to our Senior Vice President of Clinical Operations and work alongside the clinical and product teams to validate system outputs, support enhancements, and make modifications to our platform.The ideal candidate is detail-oriented with strong applied clinical knowledge and an interest in improving outcomes in autism/ABA services, enabling data-driven decision making, developing operational efficiencies, and AI-enabled healthcare solutions.What you'll own:Review ABA treatment plans and supporting clinical documentation for medical necessity and clinical appropriateness and compare platform-generated outputs, analyses, and recommendations against independent clinical review findings.Identify discrepancies, edge cases, or workflow gaps and provide structured feedback to support ongoing platform refinementCollaborate cross-functionally with clinical, product, engineering, and account management teams to help improve the product to ensure stellar customer experienceParticipate in calibration and inter-rater reliability activities to ensure consistencyAssist in development and refinement of quality assurance and improvement methodologies, audit tools, and outcome metricsPerform other data validation tasks as neededMaintain accurate and timely documentation of findings and recommendationsWhat we're looking for:Current BCBA certification in good standingMinimum 2–3 years of experience in ABA utilization management, clinical supervision, quality assurance/improvement (specific to ABA/autism services) or in an equivalent ABA leadership roleExperience reviewing ABA treatment plans and assessing clinical justification for recommended servicesKnowledge of commonly used assessment tools and scoring in ABAStrong understanding of medical necessity criteria and general payer expectations related to ABA servicesExperience auditing clinical documentation and charts for quality and complianceStrong written communication and analytical skillsExceptional attention to detail and organizational skillsAbility to work independently in a fast-paced environmentNice to have's:Experience in utilization management, care review, or prior authorization review for a payer or managed care organizationExperience with quality metrics/outcomes dataFamiliarity with multiple ABA payer guidelines, authorization processes, and documentation standardsExperience using EHRs and clinical review platformsExperience analyzing claims, utilization, or outcomes dataLocation:Based in the San Francisco Bay Area and willing to work in a hybrid work environment 2-3x per weekCompensation:$110,000-$140,000 base salary + equityBenefits and Perks:Flexible hybrid arrangement: 2-3 days/week at San Francisco office (Financial District), remote-first cultureUnlimited vacation policyPaid parental leaveMedical, dental, and vision insurancePre-tax commuter benefits401(k)Significant equity as an early employeeDirect mentorship from experienced foundersGround-floor opportunity to help build a team and cultureRegular team events and offsitesCompany-provided equipment and home office setup

Vacancy posted 4 days ago
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