Psychologist Reviewer

Centene Corporation

2d • Remote

About The Position

You could be the one who changes everything for our 28 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 Psychologist Reviewer Centene is seeking Remote Psychologist Reviewers to conduct clinical reviews for outpatient behavioral health services, including: Applied Behavior Analysis (ABA), psychological and neuropsychological testing, therapy and other community based services. Requirements: Active, unrestricted Psychologist license in one or more of the following states: Indiana, Georgia, Ohio, California, Iowa, Illinois, Washington, Pennsylvania or North Carolina We are looking for dedicated professionals who are passionate about improving the lives of our members through high-quality, evidence-based clinical review. Why Join Centene? 100% remote work flexibility Collaborative and supportive team environment Commitment to clinical excellence and meaningful impact Position Purpose: 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

Nice To Haves

• Board Certified Behavior Analyst (BCBA) BCBA-D Upon Hire preferred

Responsibilities

• 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.

Benefits

• 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.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: Ph.D. or professional degree