Remote Utilization Review Clinician (ABA/BH)

Centene Management Company LLC; Washington; Hybrid; USD 37,000 - 67,000; Full time

Benefits offered by this job

Competitive pay

Health insurance

401K and stock plans

Tuition reimbursement

Paid time off and holidays

Flexible remote/hybrid/onsite options

Job summary

Centene Management Company LLC is seeking a qualified professional to review member care and health status related to ABA services. The role includes prior authorization for BH, analysis of data to improve utilization, and coordination with providers to ensure medically appropriate ABA care.

The position requires licensure variation (LCSW/LMHC/LPC/LMFT/LMHP/BCBA or RN) depending on state, with education in behavioral health.

Qualifications

• ABA knowledge and BH utilization review understanding
• Ability to discuss ABA plans with families and providers
• Clinical knowledge in behavioral health and autism services

Responsibilities

• Review member care and ABA services for medical appropriateness
• Perform prior authorizations for BH related to ABA
• Educate members and families on ABA and BH utilization
• Collaborate with healthcare providers to discuss level of care and services provided

Job description

Centene Management Company LLC is seeking a qualified professional to review member care and health status related to ABA services. The role includes prior authorization for BH, analysis of data to improve utilization, and coordination with providers to ensure medically appropriate ABA care.

The position requires licensure variation (LCSW/LMHC/LPC/LMFT/LMHP/BCBA or RN) depending on state, with education in behavioral health.