ABA Utilization Review Specialist

Centene Corporation; Colorado; Hybrid; USD 37,000 - 66,000; Full time

Benefits offered by this job

Health insurance

401K and stock purchase plans

Tuition reimbursement

Paid time off and holidays

Flexible work schedule: remote, hybrid

Job summary

Centene Corporation is seeking a nurse or behavioral health clinician to review ABA services and related care for medical appropriateness. The role includes evaluating care before, during, and after ABA sessions and performing BH prior authorization reviews.

You will analyze BH data, discuss care levels with providers, educate families about ABA utilization, and contribute to process improvements with leadership. This position may involve remote, hybrid, field, or office work arrangements.

Qualifications

• Requires Nursing degree or Bachelor's degree with 2-4 years of related experience.
• BCBA license or equivalent required.
• Master’s degree in behavioral health for clinicians.

Responsibilities

• Evaluate member care and health status for ABA services to ensure medical appropriateness.
• Perform prior authorization reviews for BH ABA services.
• Analyze BH data to improve service utilization.
• Educate members and families about ABA and BH utilization.
• Provide feedback to leadership for process improvement.

Skills

ABA knowledge

BH utilization review

Clinical knowledge

Education

Bachelor's degree

Master’s degree in behavioral health

BCBA license

LCSW

LMHC

LPC

LMFT

LMHP

LBA

RN licensure

Job description

Centene Corporation is seeking a nurse or behavioral health clinician to review ABA services and related care for medical appropriateness. The role includes evaluating care before, during, and after ABA sessions and performing BH prior authorization reviews.

You will analyze BH data, discuss care levels with providers, educate families about ABA utilization, and contribute to process improvements with leadership. This position may involve remote, hybrid, field, or office work arrangements.