Remote ABA Utilization Review Clinician (BCBA Qualified)

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

Job summary

Centene Corporation is seeking a BCBA-certified reviewer to evaluate member care and health status related to Applied Behavioral Analysis (ABA) services. This role supports medical appropriateness, QA, and utilization review in a remote capacity with EST/CST hours.

The position requires active BCBA certification or equivalent licensure with relevant ABA experience. Strong communication and auditing skills are essential for success in this role.

Qualifications

• Strong computer skills and QA/auditing experience.
• Excellent written and verbal communication skills.
• Active BCBA certification and appropriate licensure per state requirements.
• Bachelor's degree or higher with related experience.

Responsibilities

• Evaluates member care and health status before, during, and after ABA services.
• Performs prior authorization reviews for ABA-related BH services.
• Analyzes data to improve quality and utilization of ABA services.
• Interacts with BH providers to discuss level of care and services.
• Provides education to members and families re ABA and BH utilization processes.
• Provides feedback to leadership for process improvements and new policies.
• Performs other duties as assigned.

Skills

Auditing

Quality assurance

Communication skills

Computer skills

Education

Bachelor's degree

BCBA certification

Master's degree

Job description

Centene Corporation is seeking a BCBA-certified reviewer to evaluate member care and health status related to Applied Behavioral Analysis (ABA) services. This role supports medical appropriateness, QA, and utilization review in a remote capacity with EST/CST hours.

The position requires active BCBA certification or equivalent licensure with relevant ABA experience. Strong communication and auditing skills are essential for success in this role.