Psychologist Reviewer

Company: Centene
Location: Shawnee
Posted on: November 19, 2023

Job Description:

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.


Position Purpose: 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


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:
Education/Experience: A doctorate degree in Clinical Psychology, Counseling, Behavior Analysis, or related field. 5+ experience years in Behavioral Health. Working knowledge of psychological tests and testing procedures, diagnostic evaluations and evidence based practices.

License/Certification: Unrestricted license as a Psychologist (PhD or PsyD) or Board Certified Behavior Analyst-Doctoral (BCBA-D).
Our Comprehensive Benefits Package: Flexible work solutions including remote options, hybrid work schedules and dress flexibility, Competitive pay, Paid time off including holidays, Health insurance coverage for you and your dependents, 401(k) and stock purchase plans, Tuition reimbursement and best-in-class training and development.


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.

Keywords: Centene, Midwest City , Psychologist Reviewer, Healthcare , Shawnee, Oklahoma