Clinical Quality Reviewer - BCBA

The role

This person will review ABA treatment plans and clinical documentation for medical necessity and appropriateness. They will validate system outputs and collaborate with clinical and product teams to refine the platform.

What you will do

• Review ABA treatment plans and clinical documentation for medical necessity and clinical appropriateness
• Compare platform-generated outputs and recommendations against independent clinical review findings
• Identify discrepancies, edge cases, or workflow gaps and provide structured feedback
• Collaborate cross-functionally with clinical, product, engineering, and account management teams
• Participate in calibration and inter-rater reliability activities
• 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

Required qualifications

• Current BCBA certification in good standing
• Minimum 3-5 years of experience in ABA utilization management, clinical supervision, quality assurance/improvement 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 have

• 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

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

About the company

Onos Health builds an AI-driven healthcare data platform for clinical decision-making. Their mission is to ensure healthcare dollars go toward delivering high quality care.