Jobs · Healthcare

Psychologist Reviewer

Centene Corporation · Michigan, United States · 1 wk ago
RemoteRemoteHealthcare$88k–$158k/yrFull-time

Job Description

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.

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
  • Complies with all policies and standards.

Education/Experience

  • 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 Psychologist Reviewers
  • 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

Licenses/Certifications

  • PSY - Psychologist Unrestricted License (PhD or PsyD) Upon Hire required
  • Board Certified Behavior Analyst (BCBA) BCDA Upon Hire Preferred

Pay Range

$87,700.00 - $157,800.00 per year

Benefits

  • Competitive pay
  • Health insurance
  • 401K and stock purchase plans
  • Tuition reimbursement
  • Paid time off plus holidays
  • A flexible approach to work with remote, hybrid, field or office work schedules.

Qualifications

  • Active psychologist license in North Carolina, South Carolina, Ohio, Michigan, Oregon or California

Skills

  • Passion for delivering high-quality, evidence-based behavioral health services

Benefits

  • 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.

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