Clinical Reviewer (BCBA-D - Indiana Licensed) (Remote U.S.)

Following a 2022 merger of CNSI and Kepro, Acentra Health combines clinical services, technology solutions, and data analytics to accelerate better health outcomes. This is a great time to join our team of passionate individuals working together to pursue the most effective solutions to today’s complex healthcare challenges. Our culture is fueled by passion and driven by purpose.

Board-Certified Behavioral Analyst - Doctoral (Clinical Reviewer)

• Are you an experienced board-certified Behavioral Analyst looking for a new challenge?
• Are you looking to join a team that ensures a collaborative and inviting culture where everyone can thrive?

If so, you might be our next new team member!

Who we need:

The Board-Certified Behavioral Analyst - Doctoral - Clinical Reviewer:

• Utilizes clinical expertise for the review of medical records in conjunction with contract requirements, critical thinking, and decision-making skills to determine the medical appropriateness of requested Pediatric Behavioral Therapy services.
• Performs all applicable review types as workload indicates accurately and timely.

Why us?

We are a team of experienced and caring leaders, clinicians, pioneering technologists, and industry professionals who come together to redefine expectations for the healthcare industry. State and federal healthcare agencies, providers, and employers turn to us as their vital partner to ensure better healthcare and improve health outcomes.

Singularly Focused. Mission Driven.

Accelerating Better Outcomes is our Mantra! We are mission-driven to innovate health solutions that deliver maximum value and impact.

We do this through our people.

You will have meaningful work that genuinely improves people's lives across the country. We are a company that cares about our employees, and we give you the tools and encouragement you need to achieve the finest work of your career.

Benefits are a key component of your rewards package. Our benefits are designed to provide you with additional protection, security, and support for both your career and your life away from work. Our benefits include comprehensive health plans, paid time off, retirement savings, corporate wellness, educational assistance, corporate discounts, and more.

What you’ll do:

• Review Applied Behavioral Analysis (ABA) cases.
• Second-level reviews, including reconsiderations and Peer-to-Peer discussions with requesting providers.
• Review documentation to determine the appropriate course of treatment and services based on patient diagnosis and clinical documentation.
• Utilize proper telephone etiquette and judicious use of other verbal and written communications, following Acentra policies, procedures, and guidelines.
• Maintains medical records confidentiality at all times through proper use of computer passwords, maintenance of secured files, and adherence to HIPAA policies.
• Foster positive and professional relationships with internal and external customers.
• Maintains current knowledge base related to review processes and clinical practices related to the review processes.

The list of accountabilities is not intended to be all-inclusive and may be expanded to include other duties that management may deem necessary.

What you’ll need:

Required Qualifications

• Active BCBA board certification under BACB guidelines.
• Graduate from an accredited Doctorate Degree Program in Applied Behavioral Analysis.
• Licensed to practice in Indiana.
• Experience with the Pediatric population.

Required Experience

• 4+ years of relevant clinical experience.

Preferred Experience

• 1+ year of Utilization Management/Utilization Review (UM/UR) and/or Prior Authorization experience.
• Experience reviewing/managing ABA cases.
• Experience with State Medicaid programs.

Thank You!

We know your time is valuable, and we thank you for applying for this position. Due to the high volume of applicants, only those who are chosen to advance in our interview process will be contacted. We sincerely appreciate your interest in Acentra Health and invite you to apply to future openings that may be of interest. Best of luck in your search!

~ The Acentra Health Talent Acquisition Team

EOE AA M/F/Vet/Disability