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Psychologist Reviewer

Role overview

Qualifications

  • PhD Clinical Psychology, Counseling, Behavior Analysis, or related field required
  • 2+ years Behavioral Health experience required
  • PSY - Psychologist Unrestricted License (PhD or PsyD) Upon Hire required
  • Board Certified Behavior Analyst (BCBA) preferred

Responsibilities

  • 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
  • Discuss clinical authorization questions and concerns with the Medical Director or designee regarding specific cases
  • Facilitate outpatient rounds offering clinical input and oversight related to outpatient services

Key facts

Hard skills

Other skills

  • Social Skills
  • Communication
  • Critical Thinking

About the company

Centene Corporation logo

Centene Corporation

Health Insurance (Payers)

Centene Corporation provides high-quality healthcare services to members in all 50 states. Since its founding in 1984, Centene has worked to transform the health of communities, one person at a time. Centene is the largest Medicaid managed care organization in the country and provides a portfolio of services to government sponsored healthcare programs. Centene believes that healthcare is best delivered locally. Our local health plans offer a range of health insurance solutions with a focus on providing accessible care to uninsured and under-insured individuals. Many receive benefits provided under Medicaid, including the State Children's Health Insurance Program (CHIP), as well as Aged, Blind or Disabled (ABD), Foster Care and Long Term Care (LTC), in addition to other state-sponsored/hybrid programs, and Medicare (Special Needs Plans). Centene also contracts with other healthcare and commercial organizations to provide specialty services including behavioral health management, care management software, dental benefits management, in-home health services, life and health management, managed vision, pharmacy benefits management, specialty pharmacy and telehealth services. Centene’s hiring practices reflect the composition of the members and communities we serve, allowing us to deliver quality, culturally sensitive healthcare to millions of members. Centene employees help change the world of healthcare and transform our communities. To learn more about career opportunities with Centene, visit: https://jobs.centene.com/

Company details

Company typeXLarge
IndustryHealth Insurance (Payers)
Company size10001

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Job description

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

Key Details: ​Centene is seeking Remote Psychologist Reviewers (Applied Behavior Analysis).Candidates must hold an active, unrestricted California Psychologist license.

Join Centene’s mission-driven team as a Remote Psychologist Reviewer specializing in Applied Behavior Analysis (ABA) with a focus on individuals with Autism.

We’re seeking a dedicated professional who is passionate about improving the lives of youth with Autism. The ideal candidate will also hold a BCBA certification to support our growing markets and ensure high-quality, evidence-based behavioral health 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: $87,700.00 - $157,800.00 per year

At Centene, we connect people to the care they need to live healthier lives — and the work you do here makes that impact real every day. You’ll take on meaningful challenges that directly support individuals, families, and communities, building your skills while making healthcare more accessible and effective. It’s work with a purpose you can see, backed by a team committed to improving lives well beyond the workday.
 

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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MR

Marcus Rivera

Chief Revenue Officer

m.rivera@company.com
linkedin.com/in/marcusrivera
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