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Authorization Utilization Review Bcba Jobs in Baton Rouge, LA

US Tech Solutions

Registered Nurse

Baton Rouge, LA · On-site

As a Prior Authorization Nurse, you work outside the walls of a hospital setting in a specialty area of the nursing field providing utilization management prior authorization reviews. Build strong ...

Magellan Health Services

Compliance Manager

Baton Rouge, LA · On-site +1

$77K - $124K/yr

... authorization correspondence requirements from the perspective of the Employee Retirement Income Security Act of 1974 (ERISA), National Committee for Quality Assurance (NCQA), Utilization Review ...

State of Louisiana

Pharmacist 3

Baton Rouge, LA · On-site

$7.8K - $14K/mo

... authorization statuses. Develops and approves clinical criteria for drug coverage, participates in Drug Utilization Review (DUR) activities, and recommends strategies to improve prescribing and ...

State of Louisiana

Pharmacist 3

Baton Rouge, LA · On-site

$7.8K - $14K/mo

... authorization statuses. * Develops and approves clinical criteria for drug coverage, participates in Drug Utilization Review (DUR) activities, and recommends strategies to improve prescribing and ...

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Authorization Utilization Review Bcba information

What is an authorization utilization review BCBA?

An Authorization Utilization Review BCBA is responsible for reviewing treatment plans, ensuring medical necessity, and obtaining insurance authorizations for applied behavior analysis (ABA) services. They analyze data, collaborate with clinicians, and communicate with insurance providers to optimize care while adhering to policies and guidelines. Their goal is to ensure that ABA services are both effective and appropriately funded within insurance requirements.

What does an authorization utilization review BCBA do?

An Authorization Utilization Review BCBA is primarily responsible for reviewing clinical documentation to determine the medical necessity of ABA services, preparing and submitting authorization requests to insurance companies, and responding to requests for additional information. The role involves collaborating closely with clinical staff, insurance representatives, and sometimes directly with clients or caregivers to ensure all documentation meets regulatory and payer requirements. You may also provide guidance to therapy teams on proper documentation and help streamline internal utilization review processes. This position requires balancing client advocacy with payer guidelines, making each day both detailed and dynamic.

What are the key skills and qualifications needed to thrive as an authorization utilization review BCBA?

To thrive as an Authorization Utilization Review BCBA, you need a strong background in applied behavior analysis, in-depth knowledge of utilization review processes, and active BCBA certification. Familiarity with insurance authorization platforms, electronic health record (EHR) systems, and current procedural terminology (CPT) coding is typically required. Excellent analytical skills, attention to detail, and effective communication abilities set outstanding candidates apart. These skills ensure accurate authorization decisions, regulatory compliance, and efficient collaboration with providers and insurance teams.

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Authorization Utilization Review Bcba jobs near you
Infographic showing various Authorization Utilization Review Bcba job openings in Baton Rouge, LA as of August 2026, with employment types broken down into 100% Full Time. Highlights an 50% In-person, 17% Hybrid, and 33% Remote job distribution.

Inpatient Utilization Review Clinician, Behavioral Health

Centene Corporation

Baton Rouge, LA • On-site

$27.02 - $48.55/hr

Other

Medical, Retirement, PTO

Re-posted 25 days ago

Centene rating

8.4

Company rating: 8.4 out of 10

Based on 406 frontline employees who took The Breakroom Quiz

12th of 898 rated healthcare providers

Job description

Position Purpose: Performs a clinical review and assesses care related to mental health and substance abuse. Monitors and determines if level of care and services related to mental health and substance abuse are medically appropriate.

Key Details: This position is Tuesday-Saturday or Wednesday - Sunday 8am to 5pm with holiday rotation.

  • Evaluates member’s treatment for mental health and substance abuse before, during, and after services to ensure level of care and services are medically appropriate

  • Performs prior authorization reviews related to mental health and substance abuse to determine medical appropriateness in accordance with regulatory guidelines and criteria

  • Performs concurrent review of behavioral health (BH) inpatient to determine overall health of member, treatment needs, and discharge planning

  • Analyzes BH member data to improve quality and appropriate utilization of services

  • Provides education to providers members and their families regrading BH utilization process

  • Interacts with BH healthcare providers as appropriate to discuss level of care and/or services

  • Engages with medical directors and leadership to improve the quality and efficiency of care

  • Formulates and presents cases in staffing and integrated rounds

  • Performs other duties as assigned.

  • Complies with all policies and standards.

Education/Experience: Requires Graduate of an Accredited School Nursing or Bachelor's degree and 2 – 4 years of related experience.

License to practice independently, and/or have obtained the state required licensure as outlined by the applicable state required.

Master’s degree for behavioral health clinicians required.

Clinical knowledge and ability to review and/or assess treatment plans related to mental health and substance abuse preferred.

Knowledge of mental health and substance abuse utilization review process preferred.

Experience working with providers and healthcare teams to review care services related to mental health and substance abuse preferred.

License/Certification:

  • LCSW- License Clinical Social Worker required or

  • LMHC-Licensed Mental Health Counselor required or

  • LPC-Licensed Professional Counselor required or

  • Licensed Marital and Family Therapist (LMFT) required or

  • Licensed Mental Health Professional (LMHP) required or

  • RN - Registered Nurse - State Licensure and/or Compact State Licensure required

Pay Range: $27.02 - $48.55 per hour

At Centene, we connect people to the care they need to live healthier lives — and the work you do here makes that impact real every day. You’ll take on meaningful challenges that directly support individuals, families, and communities, building your skills while making healthcare more accessible and effective. It’s work with a purpose you can see, backed by a team committed to improving lives well beyond the workday.

Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility.

Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.

Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act

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