Clinical Reviewer - Board Certified Behavior Analyst (BCBA) - United States - Remote

CNSI and Kepro are now Acentra Health! Acentra Health exists to empower better health outcomes through technology, services, and clinical expertise. Our mission is to innovate health solutions that deliver maximum value and impact.

Lead the Way is our rallying cry at Acentra Health. Think of it as an open invitation to embrace the company’s mission, actively engage in problem-solving, and take ownership of your work daily. Acentra Health offers unparalleled opportunities. In fact, you have all you need to take charge of your career and accelerate better outcomes, making this a great time to join our team of passionate individuals dedicated to being a vital partner for health solutions in the public sector.

Acentra seeks a Board Certified Behavior Analyst (BCBA) Clinical Reviewer to join our growing team.

Job Summary:

The Board-Certified Behavior Analyst – Clinical Reviewer

• Utilizes clinical expertise for reviewing 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.

** This is a Remote based position.  The selected candidate must reside and work in the United States. **

** Work Hours:  Monday – Friday from 8:00 AM – 5:00 PM Eastern. 

** The selected candidate must be legally authorized to work in the United States, now or in the future, without the need for employer visa sponsorship. **

Job Responsibilities:

• Review documentation to determine an 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 Health policies, procedures, and guidelines.
• Always maintains medical records confidentiality through proper computer password use, maintenance of secured files, and adherence to HIPAA policies.
• Fosters positive and professional relationships with internal and external customers.
• Attends training and scheduled meetings for maintenance and use of current/updated information for review.
• Maintains current knowledge base related to review processes and clinical practices related to the review processes.
• Other duties as assigned.

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

Requirements

Required Qualifications/Experience:

• Active BCBA board certification under BACB guidelines.
• Graduate from an accredited Master’s Degree Program.
• 4+ years of relevant clinical experience.
• 1+ years of Utilization Management (UM)/Utilization Review (UR) and/or Prior Authorization experience.
• Experience with the Pediatric population.
• Knowledge of the organization of medical records, medical terminology, and disease process.
• Strong clinical assessment and critical thinking skills.
• Medical record abstracting skills.
• Sound communication skills and the ability to collaborate with medical professionals.
• Ability to work in a team environment.
• Flexibility and strong organizational skills.
• Must be proficient in MS Office and Internet/web navigation.

Preferred Qualifications/Experience:

• Experience with State Medicaid programs.

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.

We do this through our people.

You will have meaningful work that genuinely improves people's lives nationwide. Our company cares about our employees, giving you the tools and encouragement, you need to achieve the finest work of your career.

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 interest you. Best of luck in your search!

~ The Acentra Health Talent Acquisition Team

Visit us at Acentra.com/careers/

EOE AA M/F/Vet/Disability

Acentra Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, status as a protected veteran, or any other status protected by applicable Federal, State, or Local law.

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Benefits

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

Compensation

The pay rate for this position is $30.00 an hour.

“Based on our compensation philosophy, an applicant’s placement in the pay range will depend on various considerations, such as years of applicable experience and skill level.”