Psychologist Reviewer

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🔥 0 minutes ago

🏄 California, Kentucky, +2 more states – Remote

🏄 California – Remote 🐎 Kentucky – Remote ⚜️ Louisiana – Remote 🌲 North Carolina – Remote

💵 $87.7k - $157.8k / year

⏰ Full Time

🟢 Junior

🟡 Mid-level

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Centene Corporation

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1984

⚕️ Healthcare Insurance

🤝 Non-profit

🌍 Social Impact

Healthcare Insurance • Non-profit • Social Impact

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 clinical information given by providers and internal criteria for medical necessity and appropriateness of care • Conduct peer reviews with psychologists, behavioral health therapists and/or Board Certified Behavior Analysts for outpatient services and/or psychological testing requests • Interact with network practitioners to provide education on best practice models and utilization management processes • Interact with the Medical Director, or designee, to discuss clinical authorization questions and concerns regarding specific cases • Respond to state, provider, and member complaints related to psychological testing or other services requiring review by a PhD/PsyD • Facilitate outpatient rounds offering clinical input and oversight related to outpatient services • Performs other duties as assigned. Complies with all policies and standards.

🎯 Requirements

• PhD Clinical Psychology, Counseling, Behavior Analysis, or related field required • 2+ years Behavioral Health required • Working knowledge of psychological tests and testing procedures, diagnostic evaluations and evidence-based practices required • For ABA Reviewers only, working knowledge of psychological tests and testing procedures, diagnostic evaluations and evidence-based practices designed for individuals with Autism Spectrum Disorder required • PSY - Psychologist Unrestricted License (PhD or PsyD) Upon Hire required • Board Certified Behavior Analyst (BCBA) BCBA-D Upon Hire preferred

🏖️ Benefits

• competitive pay • health insurance • 401K and stock purchase plans • tuition reimbursement • paid time off plus holidays • flexible approach to work with remote, hybrid, field or office work schedules