Psychologist Reviewer

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 Medicaid Team!

Are you a licensed Psychologist with a Georgia, Indiana, Iowa, Nebraska, Illinois, South Carolina or New Hampshire license with a passion for improving access to behavioral health care? Centene is looking for a Remote Psychologist to support our Medicaid plan. In this role, you’ll play a key part in outpatient and psych / neuro psych testing note reviews, appeals, and occasional peer-to-peer consultations, as well as participating in Utilization Management clinical rounds.

We’re seeking candidates who :

Hold an active Psychologist licenses in one of the following States Georgia, Indiana, Iowa, Nebraska, Illinois, South Carolina or New Hampshire

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

Thrive in a collaborative, remote work environment

This is a great opportunity to apply your clinical expertise in a non-direct care role, supporting quality care and 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