Healthcare

Quality Assurance Supervisor (BCBA)

St. Louis, MOHybridFull TimePosted 2 days ago

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Required skills

BCBA
ABA
Medicaid
Managed Care
Commercial Insurers
Payer Policies
Authorization Requirements
Medical Necessity
CASP Guidance
Regulatory Changes

Nice to have

Multiple Payers
Multiple State Medicaid Programs
Clinical Audits
Authorization Denials
Corrective-Action Processes
Policy Development

Role summary

Carelinks ABA is seeking an experienced BCBA to serve as a Quality Assurance Supervisor. This role focuses on ensuring clinical practices and documentation meet the complex requirements of payers like Medicaid and managed care organizations, while maintaining clinical meaningfulness. The QAS will translate payer policies into practical guidance, review clinical records for compliance, analyze denials, train BCBAs, develop audit processes, and monitor quality indicators. This hybrid role involves a reduced clinical caseload and offers an opportunity to influence organizational quality and protect patient care.

At Carelinks ABA, clinical quality isn't just about providing great ABA—it also means understanding the complex payer and regulatory landscape that determines how care is documented, authorized, and maintained.

We're looking for an experienced BCBA who understands both sides of that equation: strong clinical care and the payer requirements that support it. Our Quality Assurance Supervisor (QAS) will help ensure our clinical practices, documentation, and systems remain clinically meaningful while meeting the expectations of Medicaid programs, managed care organizations, commercial insurers, and other funding sources.

This is not a traditional full-caseload BCBA role. It's an opportunity for an experienced clinician with strong payer and compliance knowledge to influence clinical quality across a growing organization.

What You'll Do

You'll work closely with our VP of Clinical Operations, Area Clinical Directors, BCBAs, authorization, billing, and operational teams to bridge the gap between clinical excellence and payer expectations.

You'll:

Stay current on payer policies, authorization requirements, medical necessity standards, CASP guidance, and regulatory changes impacting ABA
Translate complex payer requirements into clear, practical guidance for our clinical teams
Review treatment plans, assessments, reassessments, progress notes, BSPs, authorization documentation, and other clinical records for quality and compliance
Analyze denials, partial approvals, authorization feedback, and payer audits to identify trends and prevent recurring issues
Train and coach BCBAs on documentation, treatment planning, medical necessity, and payer-specific expectations
Develop and maintain internal audit processes, clinical policies, SOPs, documentation templates, and quality standards
Partner across clinical, authorization, billing, and operations teams when payer changes or quality concerns require organization-wide action
Monitor clinical quality indicators and proactively identify areas of risk
Support incident reporting, SafetyCare standards, ethics and compliance initiatives, and fraud, waste, and abuse prevention
Monitor AI-supported documentation quality tools and use findings to drive clinician education and process improvement

Who We're Looking For

We're looking for more than an experienced BCBA. We want someone who truly understands the ABA payer landscape.

You should be comfortable navigating the relationship between clinical recommendations, medical necessity, documentation, authorization requirements, and reimbursement. When a payer changes its expectations or an authorization comes back with questions, you should know how to dig into the issue, understand what is driving it, and help the organization respond appropriately.

Qualifications include:

Master's degree or higher in Applied Behavior Analysis, Psychology, or a related field
Active BCBA certification in good standing
3+ years of certified clinical ABA experience, including supervisory responsibilities
Strong working knowledge of Medicaid, managed care, and commercial payer requirements within ABA
Experience with treatment authorizations, medical necessity standards, clinical documentation requirements, and payer audits or reviews
Ability to interpret payer policies and translate them into practical clinical workflows
Strong understanding of CASP guidance, ABA documentation standards, HIPAA/PHI requirements, ethics, and clinical compliance
Exceptional attention to detail and ability to recognize patterns across clinical and payer data
Strong communication, training, coaching, and cross-functional collaboration skills

Experience with multiple payers and/or multiple state Medicaid programs, clinical audits, authorization denials, corrective-action processes, policy development, or organizational quality assurance is strongly preferred.

Clinical Caseload

The QAS will remain connected to clinical practice while having the capacity to focus on organization-wide quality.

The position carries a reduced caseload of approximately 2–4 clients, with an expectation of approximately 15 billable hours per week.

Help Shape the Standard

If you're a BCBA who understands that excellent clinical care and payer compliance need to work together—and you know how to navigate both—we want to hear from you.

This is an opportunity to stay connected to clinical practice while becoming a key resource for BCBAs and leadership, helping Carelinks anticipate payer expectations, strengthen clinical systems, and protect the quality and continuity of care for the families we serve.

If that sounds like the kind of impact you're ready to make, we'd love to connect.

Ready to apply?

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