Centene Corporation ยท 4 hours ago
Psychologist Reviewer
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Hospitals and Health Care
Actively Hiring
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Responsibilities
Authorize, direct and monitor care for behavioral health and substance abuse problems according to clinical information given by providers and internal criteria for medical necessity and appropriateness of care
Conduct peer reviews with psychologist and licensed therapist/certified Behavior Analyst for outpatient 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
Analyze outlier patterns of treatment among providers
Discuss analysis overview with providers with focus of changing behaviors
Follow up of meetings with providers and facility
Collaborate with Community Providers and BH OP facilities across multiple states/health plans
Facilitate outpatient rounds offering clinical input and oversight related to outpatient services
Performs other duties as assigned
Complies with all policies and standards
Qualification
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Required
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
PSY - Psychologist Unrestricted License (PhD or PsyD) Upon Hire required
Board Certified Behavior Analyst (BCBA) BCBA-D Upon Hire required
Benefits
Health insurance
401K
Stock purchase plans
Tuition reimbursement
Paid time off plus holidays
Company
Centene Corporation
Centene Corporation is a leading healthcare enterprise committed to helping people live healthier lives.
Funding
Current Stage
Late StageLeadership Team
Recent News
Business Journals
2024-05-06
FierceHealthcare
2024-04-28
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