Behavioral Health (Autism & ABA Therapy Physician)- California (Any city, CA, US

It takes great medical minds to create powerful solutions that solve some of healthcare’s most complex challenges. Join us and put your expertise to work in ways you never imagined possible. We know you’ve honed your career in a fast-moving medical environment. While Gainwell operates with a sense of urgency, you’ll have the opportunity to work more flexible hours. And working at Gainwell carries its rewards. You’ll have an incredible opportunity to grow your career in a company that values work-life balance, continuous learning, and career development.

Summary

The Behavioral Health (Autism & ABA Therapy Physician) serves as a senior clinical subject matter expert responsible for providing medical oversight and review of behavioral health services, with a primary focus on Autism Spectrum Disorder (ASD) and Applied Behavior Analysis (ABA) therapy. This role partners with clinical, operational, and client teams to ensure medical necessity determinations are evidence-based, clinically appropriate, and aligned with state Medicaid regulations and program requirements. The Advisor Medical Expert supports quality improvement initiatives, provider engagement, and policy development to improve access to high-quality behavioral health services.

Your role in our mission

- Serve as the physician subject matter expert for Behavioral Health, Autism Spectrum Disorder (ASD), and Applied Behavior Analysis (ABA) therapy programs.

- Review complex authorization requests, appeals, and medical necessity determinations related to behavioral health and autism treatment services.

- Conduct peer-to-peer consultations with providers and apply evidence-based clinical criteria to support appropriate care decisions.

- Provide clinical guidance to utilization management, quality, case management, and operational teams.

- Interpret and apply Medicaid regulations, medical policies, and behavioral health treatment guidelines to support program compliance.

- Collaborate with clients and internal stakeholders to improve healthcare outcomes, quality initiatives, and access to behavioral health services.

What we're looking for

- Doctor of Medicine (MD) or Doctor of Osteopathic Medicine (DO) with an active, unrestricted U.S. medical license.

- Active, unrestricted license to practice medicine in the State of California.

- Board Certification in Psychiatry, Child & Adolescent Psychiatry, Developmental Behavioral Pediatrics, Neurology, or a related specialty.

- Minimum of five years of post-residency clinical experience treating individuals with Autism Spectrum Disorder and behavioral health conditions.

- Strong knowledge of ABA therapy, behavioral health treatment models, and evidence-based clinical guidelines.

- Experience with Medicaid programs, utilization management, prior authorization, appeals, or medical review activities.

- Excellent analytical, communication, and decision-making skills with the ability to work independently in a remote environment.

What you should expect in this role

- Remote role supporting Medicaid behavioral health programs. Work must be performed within the United States.

- Full-time temporary assignment expected to last 9-12 months, with potential for extension based on business needs. Standard schedule: Monday-Friday, 8:00 AM-5:00 PM; flexibility required as needed.

- Collaborate with providers, clients, and multidisciplinary healthcare teams.

- Conduct peer-to-peer reviews, complex case consultations, and medical necessity determinations for behavioral health and autism-related services.

- Review clinical documentation and contribute to high-quality, evidence-based care decisions.

This is a pipeline requisition. Applications will be reviewed on an ongoing basis.

The pay range for this position is $152,000.00 - $217,200.00 per year, however, the base pay offered may vary depending on geographic region, internal equity, job-related knowledge, skills, and experience among other factors. Put your passion