Psychologist Reviewer
| Company | Centene |
|---|---|
| Location | Iowa, USA, Jackson Township, NJ, USA, Georgia, USA, Concord, NH, USA, Nebraska, USA, Indiana, USA, Illinois, USA |
| Salary | $86000 – $154700 |
| Type | Full-Time |
| Degrees | PhD |
| Experience Level | Mid Level |
Requirements
- Active psychologist license in Indiana, Nebraska, Illinois, Iowa, Georgia, New Hampshire, or New Jersey
- PhD in Clinical Psychology, Counseling, Behavior Analysis, or related field
- 2+ years Behavioral Health experience
- Working knowledge of psychological tests and testing procedures, diagnostic evaluations, and evidence-based practices
- PSY – Psychologist Unrestricted License (PhD or PsyD) Upon Hire
- Board Certified Behavior Analyst (BCBA) BCBA-D Upon Hire
Responsibilities
- 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
- Perform other duties as assigned
- Comply with all policies and standards
Preferred Qualifications
-
No preferred qualifications provided.