Remote ABA Utilization Review Clinician — Elevate Care Quality

IntelliResume

Louisiana (MO)

On-site

USD 37,000 - 66,000

Full time

11 days ago

Application generator

Don’t send a generic resume — generate a resume and cover letter tailored to this exact role.

Get past ATS filters

Benefits offered by this job

Competitive pay

Health insurance

401K plans

Tuition reimbursement

Paid time off

Flexible schedules

Job summary

Centene seeks a Utilization Review Clinician - ABA to evaluate member care and health status before, during, and after ABA services, ensuring medical appropriateness and clinical effectiveness. This role is ideal for candidates with a strong background in behavioral health and ABA treatment.

The position includes prior authorization reviews, data analysis to improve utilization, collaboration with providers, and educating members and families about ABA processes; remote options available.

Qualifications

2–4 years of related experience required.
2+ years providing ABA services as a BCBA preferred.
Background in behavioral health and ABA treatment.

Responsibilities

Evaluate member’s care and health status before, during, and after ABA services.
Perform prior authorization reviews related to behavioral health.
Analyze behavioral health member data to improve service quality and utilization.
Interact with behavioral health healthcare providers regarding services provided.
Provide education to members and families about ABA and behavioral health utilization processes.
Provide feedback to leadership on opportunities for process improvement.
Comply with all policies and standards.
Perform other duties as assigned.