Clinical Quality Reviewer - BCBA

Job description

CLINICAL QUALITY REVIEWER - BCBA About Onos Health Onos 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. Why Onos? - Meaningful impact: Help fix what is fundamentally broken in healthcare - Direct collaboration: Work alongside experienced founders with deep healthcare and data expertise - Culture: Join a high-performing, transparent, and results-oriented team - Ownership: Significant responsibility and autonomy from day one - Opportunity: Play a pivotal role in building a fast-growing, category-defining healthcare AI company 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 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 What we're looking for: - 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 have's: - 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 Location: - Based in the San Francisco Bay Area and willing to work in a hybrid work environment 2-3x per week Compensation - $110,000-$140,000 base salary + equity Benefits and Perks - 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