You could be the one who changes everything for our 26 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility.

*REMOTE - must reside in PST, MST, or CST time zones.*

Position Purpose: The Autism Services Coordinator provides case coordination of services for beneficiaries with autism seeking access to the TRICARE Comprehensive Autism Care Demonstration (CACD). This position coordinates with referring providers, HNFS Manager of Comprehensive Autism Care, families of children with autism, and authorized Applied Behavior Analysis (ABA) providers to obtain the appropriate documentation to establish eligibility for ongoing participation in the CACD. Also coordinates for eligibility and registration into the TRICARE Extended Care Health Option (ECHO) program, which is a CACD requirement for Active Duty Family Members (ADFM).

• Demonstrates regular, reliable and predictable attendance.
• Processes authorizations received for services related to the CACD in accordance with contractual standards and includes:
• ABA provider selection in compliance with 28 day access to care appointment standards
• Gathers all relevant information by contacting appropriate physicians, BCBAs, BCBA-D or other ancillary providers and utilizing this information to authorize services as requested. Relevant information may include: treatment plans, individualized education plans (IEPs), diagnostic evaluations and Primary Care Manager (PCM) referrals.
• Documents case summary based on information received and communication with the beneficiaries and involved providers.
• Refers cases to the autism care clinical reviewers or the Manager, Comprehensive Autism Care when appropriate.
• Assists clinical review staff in the collection and data entry of BCBA, BCBA-D or other authorized Autism Spectrum Disorder (ASD) provider treatment plans.
• Coordinates directly with active duty families and their providers and Exceptional Family Member Program (EFMP) points of contact on ECHO registration requirements to assure timely ECHO registration as required for CACD guidelines.
• As a CACD subject matter expert, educates our customers and other ABA stakeholders, this includes:
• Providers (BCBA, BCBA-D) and appropriate MTF personnel regarding CACD program requirements, benefits and limitations, program related documentation requirements, and other information as appropriate, Serves as a resource for identifying other CACD ABA points of contact when necessary, such as when reimbursement education is required. .
• Collaborating as directed with the school systems and Early Intervention programs to support the beneficiary needs and to coordinate the delivery of TRICARE covered benefits to avoid duplication of services.
• Educating beneficiaries and their families to help them understand their benefits and assist them in maximizing their available benefits.
• Assists in directing the beneficiary to the appropriate providers within the MTF and HNFS provider network. This includes:
• Following the Managed Care Support Contractor (MCSC) Transfer process when transferring beneficiaries to or receiving beneficiaries from other MCSC contract regions. Collaborating with the MCSC point of contact, military liaison and established servicing providers to transition the beneficiary with minimal disruption of their health care services.
• Coordinating registration to ECHO program as required for ADFMs per TRICARE CACD guidelines.
• Other duties as assigned.

Education/Experience: Associate Degree or Equivalent, College Degree preferred. Minimum of 3 years’ experience in a medical environment; previous TRICARE and/or managed care experience desirable
Knowledge and/or previous experience working in support of beneficiaries with autism spectrum disorders (ASD) and ABA treatment preferred

Government Security/Clearance/Citizenship: As a government contractor, this position requires U. S. citizenship and proof of favorable adjudication following submission of Department of Defense form SF86 or higher security.

Our Comprehensive Benefits Package: Flexible work solutions including remote options, hybrid work schedules and dress flexibility, Competitive pay, Paid time off including holidays, Health insurance coverage for you and your dependents, 401(k) and stock purchase plans, Tuition reimbursement and best-in-class training and development.

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.