Utilization Review Clinician – ABA

Centene Corporation

. Perform reviews of members’ care and health status for Applied Behavioral Analysis services to determine medical appropriateness .

Posted 9/17/2026full-timeRemote • Louisiana • United StatesJuniorMid-Level💰 $27 - $49 per hourWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in Applied Behavioral Analysis (ABA) services, including clinical knowledge for reviewing and assessing ABA Treatment Plans, and possesses strong leadership skills to identify care improvement opportunities. Holds relevant state licensure and a Master's degree in behavioral health, ensuring compliance with regulatory guidelines.

Highest-signal resume keywords

Licensed In Louisiana Or GeorgiaBCBA CertificationMaster’s Degree In Behavioral HealthBehavioral Health Clinical KnowledgeExperience With ABA Services

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Behavioral Health Utilization ReviewABA Treatment Plan AssessmentClinical Effectiveness MonitoringData Analysis For Quality ImprovementPrior Authorization Reviews

Soft Skills

Leadership FeedbackInterpersonal CommunicationEducation And Training

Certifications & Qualifications

BCBALCSWLMHCLPCLMFTLMHPRN State/Compact Licensure

Industry Keywords

Applied Behavioral AnalysisBehavioral HealthClinical StandardsCare ImprovementHealthcare Teams

About the role

Key responsibilities & impact

Perform reviews of members’ care and health status for Applied Behavioral Analysis services to determine medical appropriateness
Monitor clinical effectiveness and efficiency of member care according to ABA guidelines
Evaluate care before, during, and after ABA services for medical appropriateness and clinical standards
Perform BH prior authorization reviews using ABA regulatory guidelines and criteria
Analyze behavioral health member data to improve quality and appropriate service utilization
Interact with behavioral health providers regarding level of care and services for members receiving ABA services
Educate members and families about ABA and the behavioral health utilization process
Provide leadership feedback on care improvement opportunities, process improvements, and new processes or policies
Comply with all policies and standards and perform other assigned duties

Requirements

What you’ll need

Must be licensed in Louisiana or Georgia
Graduate of an Accredited School of Nursing or Bachelor's degree and 2-4 years of related experience
For Enterprise Population Health, 2+ years providing ABA services as a BCBA
License to practice independently and/or state-required licensure as applicable (BCBA) required
Master’s degree for behavioral health clinicians required
Behavioral health clinical knowledge and ability to review and/or assess ABA Treatment Plans required
Knowledge of ABA services and BH utilization review process required
LCSW, LMHC, LPC, LMFT, LMHP, BCBA, RN state/compact licensure with BCBA, or LBA where required by state
Experience working with providers and healthcare teams to review Applied Behavior Analysis services preferred
BCBA with ABA treatment experience highly preferred

Benefits

Comp & perks

Competitive pay
Health insurance
401K plan
Stock purchase plans
Tuition reimbursement
Paid time off plus holidays
Flexible approach to work with remote, hybrid, field or office work schedules
Additional forms of incentives may be included in total compensation