Utilization Review Clinician – ABA

Centene Corporation

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

Posted 9/17/2026full-timeRemote • California • 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 the ability to evaluate care and health status, perform prior authorization reviews, and analyze behavioral health data to enhance service quality. Holds relevant licensure and possesses strong clinical knowledge in behavioral health and ABA treatment plans.

Highest-signal resume keywords

BCBA CertificationBehavioral Health Clinical KnowledgeABA Treatment Plan ReviewPrior Authorization ReviewIndependent Licensure

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Applied Behavioral AnalysisBehavioral Health Utilization ReviewCare EvaluationData AnalysisClinical Effectiveness Monitoring

Soft Skills

Leadership FeedbackProvider InteractionMember Education

Certifications & Qualifications

Licensed Behavior AnalystBCBALCSWLMHCLPCLMFTLMHP

Industry Keywords

Behavioral HealthHealthcare TeamsCare ImprovementClinical PoliciesABA Guidelines

About the role

Key responsibilities & impact

Perform reviews of members’ care and health status for Applied Behavioral Analysis (ABA) services to determine medical appropriateness
Monitor clinical effectiveness and efficiency of members’ care according to ABA guidelines
Evaluate 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 quality and utilization of services
Interact with behavioral health providers regarding level of care and services
Educate members and families about ABA and the behavioral health utilization process
Provide leadership feedback on care improvement opportunities, processes, and policies
Comply with all policies and standards
Perform other assigned duties

Requirements

What you’ll need

Must reside in PST, MST, or CST time zone
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 outlined by the applicable state (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
Experience working with providers and healthcare teams to review care services related to Applied Behavior Analysis Services preferred
LCSW, LMHC, LPC, LMFT, LMHP, BCBA, or required RN/BCBA licensure as applicable
Licensed Behavior Analyst (LBA) where required by state required
Independent licensure with ABA experience and BCBA 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