Remote BCBA Utilization Analyst (VA)

Sentara Healthcare Inc; Norfolk (VA); Hybrid; USD 90,000 - 120,000; Full time

Job summary

Sentara Health in Virginia offers a full-time, remote BCBA Utilization Management role focused on behavioral health services and committee-based care decisions. You will assess treatment appropriateness across care levels, leveraging evidence-based guidelines and clinical judgment.

The position requires a Master's level degree, BCBA certification, and Virginia LBA licensure, with 3+ years of related experience in managed care and ASD ABA settings. Remote work is available to VA residents.

Qualifications

• Master's degree required.
• BCBA certification required.
• Virginia Licensed Behavior Analyst (LBA) required.

Responsibilities

• Interpret criteria and policies to determine best services.
• Coordinate and monitor options for appropriate healthcare services.
• Gather clinical information and apply guidelines for coverage decisions.
• Coordinate with providers to facilitate optimal care and ABA compliance.
• Identify at-risk members and promote referrals to integrate with programs.
• Identify opportunities to improve quality and utilization of services.
• Lend clinical expertise to internal and external stakeholders in UM functions.
• Ensure accurate information is entered into claims systems for processing.

Skills

Clinical knowledge

Communication skills

Critical thinking

Education

Master's Degree

Job description

Sentara Health in Virginia offers a full-time, remote BCBA Utilization Management role focused on behavioral health services and committee-based care decisions. You will assess treatment appropriateness across care levels, leveraging evidence-based guidelines and clinical judgment.

The position requires a Master's level degree, BCBA certification, and Virginia LBA licensure, with 3+ years of related experience in managed care and ASD ABA settings. Remote work is available to VA residents.