ABA Utilization Review Clinician – Remote

Centene Corporation; United States; Hybrid; USD 37,000 - 67,000; Full time

Benefits offered by this job

Health insurance

401K and stock purchase plans

Tuition reimbursement

Paid time off and holidays

Remote/Hybrid/Office work options

Job summary

Centene Corporation is seeking a clinical reviewer to assess the medical appropriateness of Applied Behavioral Analysis (ABA) services, monitor outcomes, and ensure quality BH care for members. The role requires collaboration with behavioral health providers and education for families on ABA utilization.

The ideal candidate holds BCBA licensure (or equivalent) with a nursing or behavioral health degree and relevant experience. Flexible work arrangements and comprehensive benefits are offered.

Qualifications

• Requires licensure in applicable state(s) and BCBA for ABA oversight.
• Master’s degree in behavioral health or related field required.
• 2–4 years of related experience in ABA or behavioral health is expected.

Responsibilities

• Review member care and ABA services for medical appropriateness.
• Perform prior authorization reviews for BH services related to ABA.
• Analyze BH data to improve utilization of ABA services.
• Interact with BH providers to discuss levels of care and services.
• Educate members and families about ABA and BH utilization processes.
• Provide feedback to leadership for process improvements and policy development.
• Comply with all policies and standards.

Skills

LCSW

LMHC

LPC

LMFT

LMHP

BCBA

RN Licensure

LBA

Education

Graduate of an Accredited School of Nursing

Bachelor’s degree

Master’s degree in behavioral health

Job description

Centene Corporation is seeking a clinical reviewer to assess the medical appropriateness of Applied Behavioral Analysis (ABA) services, monitor outcomes, and ensure quality BH care for members. The role requires collaboration with behavioral health providers and education for families on ABA utilization.

The ideal candidate holds BCBA licensure (or equivalent) with a nursing or behavioral health degree and relevant experience. Flexible work arrangements and comprehensive benefits are offered.