Psychologist Reviewer

🔥 12 minutes ago

🌲 North Carolina – Remote

🌲 North Carolina – Remote

💵 $87.7k - $157.8k / year

⏰ Full Time

🟢 Junior

🟡 Mid-level

👻 Ghost score 0%

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Centene Corporation

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1984

🛡️ Insurance

💼 Consulting

🏥 Healthcare

Insurance • Consulting • Healthcare

Centene Corporation is a leading provider of government-sponsored healthcare services, specializing in delivering affordable and high-quality healthcare solutions. For over 40 years, Centene has focused on transforming the health of communities by expanding access to Medicaid, Medicare, and Health Insurance Marketplace services, as well as serving military communities through the TRICARE program. As the largest Medicaid managed care organization and a key participant in the Marketplace, Centene emphasizes localized healthcare delivery combined with strong partnerships with nonprofit organizations to meet the unique needs of its members. Centene is also committed to corporate sustainability and social responsibility, prioritizing environmental stewardship and ethical governance to enhance the well-being of the communities it serves.

📋 Description

• Authorize, direct, and monitor care for behavioral health and/or substance abuse problems according to provider clinical information and internal medical-necessity criteria • Conduct peer reviews with psychologists, behavioral health therapists, and/or Board Certified Behavior Analysts for outpatient services and psychological testing requests • Interact with network practitioners to provide education on best-practice models and utilization-management processes • Discuss clinical authorization questions and case concerns with the Medical Director or designee • Respond to state, provider, and member complaints related to psychological testing or other services requiring PhD/PsyD review • Facilitate outpatient rounds and provide clinical input and oversight for outpatient services • Comply with all policies and standards • Perform other duties as assigned

🎯 Requirements

• PhD in Clinical Psychology, Counseling, Behavior Analysis, or related field required • 2+ years of Behavioral Health experience required • Working knowledge of psychological tests and testing procedures, diagnostic evaluations, and evidence-based practices required • For ABA Reviewers, working knowledge of psychological tests and testing procedures, diagnostic evaluations, and evidence-based practices designed for individuals with Autism Spectrum Disorder required • Unrestricted Psychologist License (PhD or PsyD) required upon hire • Active psychologist license in Arkansas, Kentucky, North Carolina, or New Jersey • Licenses in other states may be considered if the candidate is willing and able to obtain additional required licensure • BCBA certification preferred

🏖️ Benefits

• Health insurance • 401K plan • Stock purchase plan • Tuition reimbursement • Paid time off • Paid holidays • Flexible approach to remote, hybrid, field, or office work schedules • Additional forms of incentives may be included in total compensation • Equal opportunity employer committed to diversity