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Full Time Bcba Autism Utilization Review Jobs (NOW HIRING)

Nationwide Children's Hospital

Conducts utilization reviews of behavioral health cases to determine medical necessity, appropriateness of care, and adherence to clinical guidelines. * Communicates with healthcare teams and third ...

Centene

Utilization Review Clinician - ABA

$27.02 - $48.55/hr

BCBA Certificate * ABA Treatment Experience * Technological Savvy * Excellent Written and Oral ... autism spectrum disorder needs and clinical standards * Performs prior authorization reviews ...

Centene

Utilization Review Clinician - ABA

$27.02 - $48.55/hr

Candidates must be BCBA certified and have ABA treatment experience. Technological savvy and ... autism spectrum disorder needs and clinical standards * Performs prior authorization reviews ...

Centene

Utilization Review Clinician - ABA

$27.02 - $48.55/hr

... autism spectrum disorder needs and clinical standards * Performs prior authorization reviews ... For Enterprise Population Health 2+ years providing ABA services as a BCBA License to practice ...

Prime Healthcare

Utilization Review Tech

Lynwood, CA · On-site

$23 - $24.45/hr

The Utilization review tech essentially works to coordinate the utilization review and appeals ... e. full-time or part-time. The current compensation range for this role is $23.00 to $24.45. The ...

Gbmc

Two (2) years of Utilization Review and Case Management experience which includes utilization review processes and discharge planning, and working with Re-Admission Initiatives preferred. Skills:

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Full Time Bcba Autism Utilization Review information

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$47.5K

$89.1K

$149K

How much do full time bcba autism utilization review jobs pay per year?

As of Aug 31, 2026, the average yearly pay for full time bcba autism utilization review in the United States is $89,075.00, according to ZipRecruiter salary data. Most workers in this role earn between $74,000.00 and $90,500.00 per year, depending on experience, location, and employer.

What is the difference between Full Time Bcba Autism Utilization Review vs Full Time Bcba Autism Case Manager?

AspectFull Time Bcba Autism Utilization ReviewFull Time Bcba Autism Case Manager
CredentialsBCBA certification, autism-specific knowledgeBCBA certification, case management experience
Work EnvironmentInsurance review teams, healthcare settingsCommunity clinics, schools, healthcare agencies
Employer & IndustryInsurance companies, healthcare providersBehavioral health agencies, schools
Primary FocusReviewing autism treatment authorizationsCoordinating autism services & support

While both roles require BCBA certification and focus on autism, the Full Time Bcba Autism Utilization Review primarily involves reviewing treatment authorizations within insurance or healthcare settings. In contrast, the Full Time Bcba Autism Case Manager emphasizes coordinating services and supporting clients directly. Understanding these differences helps professionals choose the role that best aligns with their skills and career goals.

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Utilization Review Specialist - Autism

Nationwide Children's Hospital

Columbus, OH • On-site

Full-time

Re-posted 10 days ago

Nationwide Children's Hospital rating

6.9

Company rating: 6.9 out of 10

Based on 131 frontline employees who took The Breakroom Quiz

551st of 1,064 rated hospitals

Job description

Overview:
Schedule: Monday-Friday (8:00am-4:30pm)
Position is work from home after a 90 day in-office training period.
Job Description Summary:
Reviews behavioral health cases to determine medical necessity and appropriateness of care, ensuring compliance with established guidelines and policies. Performs pre-certifications, pre-authorizations, re-authorization, concurrent utilization reviews, retrospective reviews, and denial management. Interacts with staff and departments of the hospital to facilitate appropriate, cost-effective patient care.
Job Description:
Essential Functions:
  • Conducts utilization reviews of behavioral health cases to determine medical necessity, appropriateness of care, and adherence to clinical guidelines.
  • Communicates with healthcare teams and third-party payors to ensure the delivery of quality care and optimum payment.
  • Assists with retrospective reviews and denial management to maintain appropriate and cost-effective patient care.
  • Documents all case reviews and maintains accurate records of all clinical activities and coverage information.
  • Provides education and support regarding utilization review and management activities and processes.
  • Analyzes clinical data to identify trends and patterns that may impact patient care. Participates in quality improvement initiatives to enhance the overall delivery of behavioral health services.
  • Facilitates reimbursement by communicating with payers, other staff, patients, and families concerning status of funding and required actions.

Education Requirement:
Bachelor's Degree in Social Work, Psychology, or related field, required.
Licensure Requirement:
(not specified)
Certifications:
(not specified)
Skills:
  • Excellent written and verbal communication and interpersonal skills.
  • Excellent customer service and organizational skills.
  • Working knowledge of CMS and other review agency standards.
  • Proficient with software applications including CM, payer web applications, MITS, and others.

Experience:
  • Three years of behavioral health experience, required.
  • One year of experience in pediatric care or services, required.
  • Utilization review or utilization management experience, preferred.

Physical Requirements:
OCCASIONALLY: Bend/twist, Climb stairs/ladder, Flexing/extending of neck, Lifting / Carrying: 0-10 lbs, Reaching above shoulder, Squat/kneel
FREQUENTLY: Standing, Walking
CONTINUOUSLY: Audible speech, Color vision, Computer skills, Decision Making, Depth perception, Hand use: grasping, gripping, turning, Hearing acuity, Interpreting Data, Peripheral vision, Problem solving, Repetitive hand/arm use, Seeing - Far/near, Sitting
Additional Physical Requirements performed but not listed above:
(not specified)
"The above list of duties is intended to describe the general nature and level of work performed by individuals assigned to this classification. It is not to be construed as an exhaustive list of duties performed by the individuals so classified, nor is it intended to limit or modify the right of any supervisor to assign, direct, and control the work of employees under their supervision. EOE M/F/Disability/Vet"

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About Nationwide Children's Hospital

Sourced by ZipRecruiter

Nationwide Children's Hospital, established in 1894, is a leading pediatric healthcare system based in Columbus, Ohio, United States. They serve as a primary pediatric network, providing wellness, preventive, diagnostic, treatment, and rehabilitative care for infants, children, adolescents, and adults with congenital disease. Being the third-largest pediatric hospital in the nation, Nationwide Children's Hospital prides itself on its relentless commitment to children and their families, driven by their core values of respect, integrity, determination, empathy, and solidarity. The institution's comprehensive mission is to enhance the health of children by providing high-quality, family-centered care, conducting groundbreaking research, advocating for pediatric health, and training top healthcare professionals.

Industry

Hospitals

Company size

10,000+ Employees

Headquarters location

Columbus, OH, US

Year founded

1892

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