ABA Utilization Review Clinician – Remote/Hybrid (FL)

Centene Corporation; Tallahassee (FL); On-site; USD 65,000 - 90,000; Full time

Benefits offered by this job

Health insurance

401K and stock plans

Tuition reimbursement

Paid time off and holidays

Remote/hybrid/work schedule options

Job summary

Centene Corporation in Florida seeks a qualified professional to review ABA services for medical appropriateness, monitor outcomes, and coordinate with BH providers. The role emphasizes prior authorization, performance improvement, and education for members and families.

The candidate should hold BCBA or state licensure, with 2–4 years of related experience and a master’s degree in behavioral health. The position requires residing in Florida and a Monday–Friday 8–5 EST schedule.

Qualifications

• Graduate degree in nursing or bachelor’s with 2–4 years of related experience.
• 2+ years ABA services experience as a BCBA for Enterprise Population Health.
• State licensure as applicable (BCBA or other).
• Master’s degree in behavioral health required.
• Knowledge of ABA services and BH utilization review.

Responsibilities

• Evaluate member care/health status before, during, and after ABA services to ensure medical appropriateness.
• Perform prior authorization reviews for BH to determine medical appropriateness.
• Analyze BH data to improve quality and utilization of services.
• Interact with BH providers to discuss level of care and services.
• Educate members and families re ABA and BH utilization process.
• Provide leadership feedback on care improvements and new policies.
• Comply with all policies and standards.

Skills

ABA knowledge

BH utilization review

Prior authorization

Education

Bachelor's degree

Master’s degree in Behavioral Health

BCBA certification

LCSW

LMHC

LPC

LMFT

LMHP

Job description

Centene Corporation in Florida seeks a qualified professional to review ABA services for medical appropriateness, monitor outcomes, and coordinate with BH providers. The role emphasizes prior authorization, performance improvement, and education for members and families.

The candidate should hold BCBA or state licensure, with 2–4 years of related experience and a master’s degree in behavioral health. The position requires residing in Florida and a Monday–Friday 8–5 EST schedule.