Board Certified Behavior Analyst-Doctoral (BCBA-D) PRN (Remote U.S.)

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 mission of the company; to actively engage in problem-solving; and to take ownership of your work every day. Acentra Health offers you 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 Health is seeking a Board Certified Behavior Analyst-Doctoral (BCBA-D) PRN (Remote U.S.) to join our growing team.

Job Summary:

• The purpose of this position is to utilize clinical expertise, critical thinking, and decision-making skills to review medical records against appropriate criteria in conjunction with contract requirements to determine medical appropriateness of Autism Spectrum Disorder Services, while maintaining production goals and QA standards.

Responsibilities:

• Discuss complicated Utilization Management reviews or clinical scenarios with Utilization Management Clinical Reviewers.
• Participate in activities specific to contractual arrangements, i.e., Reconsiderations, Peer-to-Peer discussions, and Fair Hearings.
• Review and interpret patient records to assess medical necessity and appropriateness of care, ensuring documentation supports requested services.
• Serve as a doctoral-level consultant to determine approvals and provide clear, detailed rationale for any denials in outgoing correspondence.
• Conduct ongoing evaluations of review processes to identify opportunities for improvement and implement changes as needed.
• Ensure accuracy and timeliness of all case reviews in compliance with contractual requirements.
• Monitor daily workload and queues, adjusting schedules and priorities to meet departmental demands.
• Participate in the client meetings as needed.
• Build and maintain positive, professional relationships with internal teams and external stakeholders.
• Participate in required training sessions and meetings, staying current with clinical practices, policies, and regulatory updates for accurate case review.
• Communicate effectively using appropriate telephone etiquette and written correspondence, adhering to organizational policies and guidelines.
• Cross train on multiple contracts to provide flexibility and meet client needs.
• Maintain strict confidentiality of medical records through secure systems, password protection, and compliance with HIPAA regulations.
• Read, understand, and adhere to all corporate policies including policies related to HIPAA and its Privacy and Security Rules.

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

Required Qualifications/Experience:

• Active, unrestricted Licensed Behavior Analyst (LBA) issued by the state of Indiana, per state requirements.
• Certified by the Behavior Analyst Certification Board (BACB) as a BCBA with a Doctoral designation (BCBA-D), in accordance with contract requirements.
• Doctoral degree in Applied Behavior Analysis, Psychology, Education, or a related field.
• 5+ years of recent clinical experience in the behavior analysis field.
• 1+ years of experience in Utilization Management, Utilization Review or Prior Authorization.
• Strong clinical assessment and critical thinking skills.
• Proficiency in medical necessity review.
• Must reside in the United States.

Preferred Qualifications/Experience:

• Experience with State Medicaid programs.
• Ability to work independently in a remote environment and adapt to a demanding workload.
• Strong organizational skills with attention to detail.
• Excellent written and verbal communication skills.
• Proficient in Microsoft Office Suite, and collaboration tools such as Microsoft Teams.

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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 Health

EEO 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, national origin, disability, status as a protected veteran or any other status protected by applicable Federal, State or Local law.

Compensation

The pay range for this position is listed below.

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