Psychologist Reviewer

Centene Corporation•Remote-MI, MI

1d•$87,700 - $157,800•Remote

About The Position

Centene is seeking a Remote Psychologist Reviewer with experience in outpatient behavioral health, Applied Behavior Analysis (ABA), neuropsychology, managed care, or community-based services to review psychological testing and treatment documentation for medical necessity and quality of care. This is an excellent opportunity for a licensed psychologist who enjoys applying their clinical knowledge in a non-traditional setting while maintaining a consistent Monday–Friday schedule (8:00 AM–5:00 PM). Ideal candidates will hold an active psychologist license in North Carolina, South Carolina, Ohio, Missouri, or Oregon and bring a passion for delivering high-quality, evidence-based behavioral health services. Make an Impact from Anywhere. Join a mission-driven organization where your clinical expertise helps ensure members receive the appropriate behavioral health services they need to thrive.

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
Active psychologist license in North Carolina, South Carolina, Ohio, Missouri, or Oregon

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.