Psychologist Reviewer

Reposted 2 Days Ago
Be an Early Applicant
6 Locations
Remote
86K-155K Annually
Mid level
Healthtech
The Role
As a Psychologist Reviewer, you will review outpatient and psych/neuropsych testing, manage appeals, consult peers, and support Medicaid quality care.
Summary Generated by Built In

You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility.
 

Centene is Hiring a Remote Psychologist – Join Our Oklahoma Medicaid Team!

Are you a licensed Psychologist with a passion for improving access to behavioral health care? Centene is seeking a Remote Psychologist to support our Oklahoma Medicaid plan. In this role, you’ll play a key part in outpatient and psych/neuropsych testing note reviews, appeals, and occasional peer-to-peer consultations, as well as participating in Utilization Management clinical rounds.

We welcome applicants who hold one of the following licenses Oklahoma, Arizona, Texas, Kentucky, California, Nevada, Nebraska, Kansas Psychologist license — or are licensed in another state and willing to obtain an Oklahoma license.

We’re seeking candidates who:

  • Hold (or are willing to obtain) an active Oklahoma Psychologist license

  • Are familiar with Medicaid guidelines, prior authorization, and telehealth practices

  • Thrive in a collaborative, remote work environment

This is an excellent opportunity to apply your clinical expertise in a non-direct care, remote role, supporting quality care and improved outcomes for the Medicaid population.

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

  • Performs other duties as assigned.

  • 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 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) BCBA-D Upon Hire preferred:

Pay Range: $86,000.00 - $154,700.00 per year

Centene offers a 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.  Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status.  Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility.

Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.


Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act

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The Company
Columbus, GA
19,002 Employees
Year Founded: 1984

What We Do

Centene provides healthcare solutions to individuals across the United States with more than 23 million members nationwide.

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