(BCBA) Behavioral Health Clinical Reviewer

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. We invite you to embrace our mission, actively engage in problem-solving, and take ownership of your work every day. As a vital partner for health solutions in the public sector, Acentra Health offers unparalleled opportunities to accelerate your career and make a meaningful difference.

About the role

The BCBA Behavioral Health Clinical Reviewer conducts administrative and process-based reviews of medical records related to Applied Behavior Analysis (ABA) services. This role evaluates documentation against established criteria and contractual requirements to determine medical appropriateness, ensuring compliance, accuracy, and completeness of ABA documentation. This position is remote within the United States but based out of Minnesota, with a schedule aligned to regular business hours in the Central Time Zone. Candidates must be eligible to obtain a certification as a Minnesota Licensed Behavioral Analyst (LBA) upon hire.

Responsibilities

• Conduct prospective, concurrent, and retrospective reviews of Behavioral Health services, with a focus on Applied Behavior Analysis (ABA).
• Evaluate age-appropriate testing, evaluation, and assessment tools to determine the appropriateness of ABA therapy.
• Ensure accuracy and timeliness of all review types in accordance with contract requirements.
• Monitor and manage daily workload and review queues, adjusting schedules as needed to meet departmental demands.
• Collaborate with the Supervisor on quality monitoring activities, identifying areas for improvement and supporting implementation efforts.
• Maintain current knowledge of review processes, clinical practices, and relevant guidelines.
• Serve as the first-line reviewer for ABA prior authorization requests, based on workload needs.
• Act as a liaison and resource for providers, addressing client/patient service issues and facilitating problem resolution.
• Foster positive, professional relationships with internal and external stakeholders to support effective review processes.
• Participate in training sessions and scheduled meetings to stay updated on review protocols and industry standards.
• Adhere to all corporate policies, including those related to HIPAA Privacy and Security Rules.

Requirements

• Master’s degree in psychology, Behavior Analysis, or another relevant field.
• 4+ years of experience in Applied Behavior Analysis (ABA) or a related clinical field.
• Certification as a Board-Certified Behavior Analyst (BCBA).
• Eligibility to obtain a certification as a Minnesota Licensed Behavioral Analyst (LBA) upon hire.

Qualifications

• Excellent written and verbal communication skills and the ability to collaborate with families and other medical professionals.
• Utilization review and/or case management experience.
• Medicaid/Medicare/Commercial experience.
• Understanding of ABA principles, clinical practices, and therapeutic techniques.
• Medical record abstracting skills, including knowledge of medical record organization, medical terminology, and disease processes.
• Excellent organizational skills.
• Strong clinical assessment and critical thinking skills.

Benefits

Our benefits are designed to provide additional protection, security, and support for both your career and your life away from work. Benefits include:

• Comprehensive health plans.
• Paid time off.
• Retirement savings.
• Corporate wellness programs.
• Educational assistance.
• Corporate discounts.

Pay

The pay range for this position is USD $28.37 - USD $39.19 per hour. An applicant’s position placement in the pay range will depend on various considerations, such as years of applicable experience and skill level.