Psychologist Reviewer

Centene Corporation

3d•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. Centene is Hiring – Remote Psychologist Reviewers (ABA) Centene is seeking Remote Psychologist Reviewers (Applied Behavior Analysis). Candidates must hold an active psychologist license in Indiana. Licensure in additional states will be considered, provided the selected candidate is willing and able to obtain required additional state licenses as needed. Join Centene’s mission-driven team as a Remote Psychologist Reviewer specializing in Applied Behavior Analysis (ABA) with a focus on individuals with Autism. We’re seeking a dedicated professional who is passionate about improving the lives of youth with Autism. The ideal candidate will also hold a BCBA certification to support our growing markets and ensure high-quality, evidence-based behavioral health care. Why Join Us? 100% remote flexibility Meaningful work impacting care for youths with Autism Be part of a collaborative, supportive team committed to clinical excellence 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.