Opportunity Description
You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility.
**Utilization Review Clinician – ABA (Remote)**
Centene is seeking a Utilization Review Clinician – ABA to conduct prior authorization reviews for Applied Behavior Analysis (ABA) treatment services. This role evaluates clinical documentation for medical necessity and ensures compliance with established clinical guidelines and health plan policies.
**Schedule:** Monday–Friday, 8:00 AM–5:00 PM (Remote)
**Preferred Qualifications**
+ Experience with ABA treatment and clinical documentation review
+ Strong knowledge of medical necessity criteria and utilization management principles
+ Prior authorization, utilization management, or managed care experience
+ Exp...
**Utilization Review Clinician – ABA (Remote)**
Centene is seeking a Utilization Review Clinician – ABA to conduct prior authorization reviews for Applied Behavior Analysis (ABA) treatment services. This role evaluates clinical documentation for medical necessity and ensures compliance with established clinical guidelines and health plan policies.
**Schedule:** Monday–Friday, 8:00 AM–5:00 PM (Remote)
**Preferred Qualifications**
+ Experience with ABA treatment and clinical documentation review
+ Strong knowledge of medical necessity criteria and utilization management principles
+ Prior authorization, utilization management, or managed care experience
+ Exp...
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