Centene

1 day ago

Utilization Review Clinician - ABA

✓ Verified Job

Canonical indexed version, validated from employer's careers page.

Source: Company careers pageValidated by: Fursa AI

Last checked: 12 hours agoStatus: Live

Job Summary

Perform utilization reviews for members receiving Applied Behavior Analysis (ABA) services to determine medical appropriateness. Evaluate care and health status before, during, and after ABA services, conduct prior authorization reviews, and analyze behavioral health member data to improve quality and appropriate utilization. Collaborate with behavioral health providers, educate members and families on ABA/BH utilization processes, and provide feedback to leadership on process and policy improvements.

Location: Missouri

Workplace: Remote

Employment Type: Full time

Job Function: Healthcare (Clinical, Medical, Wellness)

Seniority: Mid level

Key Responsibilities

•Review members’ care and health status before, during, and after ABA services to ensure medical appropriateness for behavioral health and/or autism spectrum disorder needs.
•Perform prior authorization reviews related to behavioral health to determine medical appropriateness under ABA regulatory guidelines and criteria.
•Analyze behavioral health member data to improve quality and appropriate utilization of services.
•Interact with behavioral health healthcare providers to discuss level of care and/or services provided to members receiving ABA services.
•Provide education to members and their families regarding the ABA and behavioral health utilization process, and provide feedback to leadership on opportunities for process improvement.

Pay and Benefits

Salary: USD 27.02 - 48.55 hourly

Perks:Health Insurance401kEquityPaid LeaveRemote Work

Key Requirements

•Master’s degree for behavioral health clinicians.
•2-4 years of related experience (2+ years providing ABA services as a BCBA for Enterprise Population Health).
•Knowledge of ABA services and the behavioral health utilization review process, including ability to review and/or assess ABA treatment plans.
•BCBA Certificate and ABA treatment experience (and/or other state-required licensure to practice independently as outlined by the applicable state).
•Excellent written and oral communication skills, including assessments skills.

Experience:2-4 years

Education:Master's

Skills:CommunicationProcess improvementData analysisProvider collaboration

Licenses:LCSWLMHCLPCLMFTLMHPRNLBA

Certifications:BCBA Certificate

Company Brief

Centene

Centene Corporation is a diversified, multinational healthcare enterprise that provides government-sponsored and commercial healthcare programs and services, specializing in Medicaid, Medicare, and specialty benefits management across the United States.

Industry: Health Insurance (Payers)

Company Size: Enterprise (1,001+ employees)

Revenue: USD 1B+

Growth: Public Company

Valuation: Public Company (Market Cap in USD)

Funding: IPO / Publicly Listed

Headquarters: St. Louis, United States

Founded: 1984

Website LinkedIn

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Centene

1 day ago

Utilization Review Clinician - ABA

✓ Verified Job

Canonical indexed version, validated from employer's careers page.

Source: Company careers pageValidated by: Fursa AI

Last checked: 12 hours agoStatus: Live

Job Summary

Location: Missouri

Workplace: Remote

Employment Type: Full time

Job Function: Healthcare (Clinical, Medical, Wellness)

Seniority: Mid level

Key Responsibilities

•Review members’ care and health status before, during, and after ABA services to ensure medical appropriateness for behavioral health and/or autism spectrum disorder needs.
•Perform prior authorization reviews related to behavioral health to determine medical appropriateness under ABA regulatory guidelines and criteria.
•Analyze behavioral health member data to improve quality and appropriate utilization of services.
•Interact with behavioral health healthcare providers to discuss level of care and/or services provided to members receiving ABA services.
•Provide education to members and their families regarding the ABA and behavioral health utilization process, and provide feedback to leadership on opportunities for process improvement.

Pay and Benefits

Salary: USD 27.02 - 48.55 hourly

Perks:Health Insurance401kEquityPaid LeaveRemote Work

Key Requirements

•Master’s degree for behavioral health clinicians.
•2-4 years of related experience (2+ years providing ABA services as a BCBA for Enterprise Population Health).
•Knowledge of ABA services and the behavioral health utilization review process, including ability to review and/or assess ABA treatment plans.
•BCBA Certificate and ABA treatment experience (and/or other state-required licensure to practice independently as outlined by the applicable state).
•Excellent written and oral communication skills, including assessments skills.

Experience:2-4 years

Education:Master's

Skills:CommunicationProcess improvementData analysisProvider collaboration

Licenses:LCSWLMHCLPCLMFTLMHPRNLBA

Certifications:BCBA Certificate

Company Brief

Centene

Industry: Health Insurance (Payers)

Company Size: Enterprise (1,001+ employees)

Revenue: USD 1B+

Growth: Public Company

Valuation: Public Company (Market Cap in USD)

Funding: IPO / Publicly Listed

Headquarters: St. Louis, United States

Founded: 1984

Website LinkedIn