Centene Corporation · 23 hours ago
Psychologist Reviewer
United States
Full-time
Remote
Entry, Mid Level
$88K/yr - $158K/yr
2+ years expCentene Corporation is a diversified national organization that is seeking Remote Psychologist Reviewers to conduct clinical reviews for outpatient behavioral health services. The role involves authorizing, directing, and monitoring care for behavioral health and substance abuse problems, while also providing education to network practitioners on best practices and utilization management processes.
Hospital & Health Care
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
Qualification
Required
Active, unrestricted Psychologist license in one or more of the following states: Indiana, Georgia, Ohio, California, Iowa, Illinois, Washington, Pennsylvania or North Carolina
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
Preferred
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
Company
Centene Corporation
Centene Corporation is a leading healthcare enterprise committed to helping people live healthier lives.
10001+ employees
Funding
Current Stage
Late StageLeadership Team
Beth Johnson
President and CEO, Coordinated Care
Clyde White
President & CEO (New Hampshire Healthy Families)
Recent News
Business Journals
2024-05-06
FierceHealthcare
2024-04-28
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