Psychologist Reviewer
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Job Description
Remote psychologist reviewing ABA, autism care, and behavioral health services for Centene. Authorizing care, conducting peer reviews, and advising providers on evidence-based treatment.
Responsibilities:
- Authorize, direct, and monitor care for behavioral health and/or substance abuse problems according to provider clinical information and internal medical-necessity criteria
- Conduct peer reviews with psychologists, behavioral health therapists, and/or Board Certified Behavior Analysts for outpatient services and psychological testing requests
- Interact with network practitioners to provide education on best-practice models and utilization-management processes
- Discuss clinical authorization questions and case concerns with the Medical Director or designee
- Respond to state, provider, and member complaints related to psychological testing or other services requiring PhD/PsyD review
- Facilitate outpatient rounds and provide clinical input and oversight for outpatient services
- Comply with all policies and standards
- Perform other duties as assigned
Requirements:
- PhD in Clinical Psychology, Counseling, Behavior Analysis, or related field required
- 2+ years of Behavioral Health experience required
- Working knowledge of psychological tests and testing procedures, diagnostic evaluations, and evidence-based practices required
- For ABA Reviewers, working knowledge of psychological tests and testing procedures, diagnostic evaluations, and evidence-based practices designed for individuals with Autism Spectrum Disorder required
- Unrestricted Psychologist License (PhD or PsyD) required upon hire
- Active psychologist license in Arkansas, Kentucky, North Carolina, or New Jersey
- Licenses in other states may be considered if the candidate is willing and able to obtain additional required licensure
- BCBA certification preferred
Benefits:
- Health insurance
- 401K plan
- Stock purchase plan
- Tuition reimbursement
- Paid time off
- Paid holidays
- Flexible approach to remote, hybrid, field, or office work schedules
- Additional forms of incentives may be included in total compensation
- Equal opportunity employer committed to diversity
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