Clinical Quality Reviewer - BCBA
About The Position
Onos Health is seeking a Board Certified Behavior Analyst (BCBA) with deep clinical expertise to support their mission of ensuring every healthcare dollar goes toward delivering the highest quality care. This role will help refine AI-driven healthcare data platform models and products, specifically focusing on improving quality in autism/ABA services. The BCBA will report directly to the Senior Vice President of Clinical Operations and collaborate with clinical, product, and engineering teams to validate system outputs, support enhancements, and make modifications to the platform. The ideal candidate will have strong applied clinical knowledge, a detail-oriented approach, and an interest in improving outcomes in autism/ABA services, enabling data-driven decision making, developing operational efficiencies, and AI-enabled healthcare solutions.
Requirements
- Current BCBA certification in good standing
- Minimum 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 role
- Experience reviewing ABA treatment plans and assessing clinical justification for recommended services
- Knowledge of commonly used assessment tools and scoring in ABA
- Strong understanding of medical necessity criteria and general payer expectations related to ABA services
- Experience auditing clinical documentation and charts for quality and compliance
- Strong written communication and analytical skills
- Exceptional attention to detail and organizational skills
- Ability to work independently in a fast-paced environment
Nice To Haves
- Experience in utilization management, care review, or prior authorization review for a payer or managed care organization
- Experience with quality metrics/outcomes data
- Familiarity with multiple ABA payer guidelines, authorization processes, and documentation standards
- Experience using EHRs and clinical review platforms
- Experience analyzing claims, utilization, or outcomes data
Responsibilities
- 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 refinement.
- Collaborate cross-functionally with clinical, product, engineering, and account management teams to help improve the product to ensure stellar customer experience.
- Participate in calibration and inter-rater reliability activities to ensure consistency.
- Assist in development and refinement of quality assurance and improvement methodologies, audit tools, and outcome metrics.
- Perform other data validation tasks as needed.
- Maintain accurate and timely documentation of findings and recommendations.
Benefits
- Flexible hybrid arrangement: 2-3 days/week at San Francisco office (Financial District), remote-first culture
- Unlimited vacation policy
- Paid parental leave
- Medical, dental, and vision insurance
- Pre-tax commuter benefits
- 401(k)
- Significant equity as an early employee
- Direct mentorship from experienced founders
- Ground-floor opportunity to help build a team and culture
- Regular team events and offsites
- Company-provided equipment and home office setup
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
No Education Listed
