Psychologist Reviewer

Centene Management Company LLC; California; Hybrid; USD 90,000 - 120,000; Full time

Benefits offered by this job

Competitive pay

Health insurance

401K plan

Tuition reimbursement

Paid time off

Flexible schedules

Total compensation

Job summary

Centene Management Company LLC is seeking a Remote Psychologist Reviewer specializing in ABA and autism care to support youth with high-quality behavioral health services. You will work from home reviewing cases and advising on medical necessity and appropriateness of care.

Active California license required with eligibility in additional states; BCBA-D preferred. The role requires 2+ years in behavioral health, expertise in testing and evidence-based practices, and a commitment to accessible,

Qualifications

• PhD in Clinical Psychology, Counseling, Behavior Analysis, or related field; 2+ years in Behavioral Health.
• Experience with psychological tests, diagnostic evaluations, and evidence-based practices.

Responsibilities

• Conduct peer reviews with psychologists, therapists, and BCBA-Ds for outpatient services and testing requests.
• Educate network practitioners on best practice models and utilization management processes.
• Discuss clinical authorization questions with the Medical Director on specific cases.
• Respond to state/provider/member complaints related to testing or reviews.
• Facilitate outpatient rounds with clinical input and oversight.
• Perform other duties as assigned.
• Comply with all policies and standards.

Skills

Peer reviews

Utilization management

Clinical collaboration

Education

PhD in Clinical Psychology

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

Make an impact from home as a Remote Psychologist Reviewer specializing in Applied Behavior Analysis (ABA) and autism care. Centene is seeking a mission-driven psychologist to support youth through high-quality, evidence-based behavioral health care. Candidates must hold an active psychologist license in Arkansas, California, Kentucky, North Carolina or New Jersey. Licenses in other states may be considered if the candidate is willing and able to obtain additional required licensure. BCBA certification is preferred.

Duties & 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.
• 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

Licenses / Certifications

• PSY - Psychologist Unrestricted License (PhD or PsyD) Upon Hire required
• Board Certified Behavior Analyst (BCBA) BCBA-D Upon Hire preferred

Employer Details

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.

Benefits

• competitive pay
• health insurance
• 401K and stock purchase plans
• tuition reimbursement
• paid time off plus holidays
• 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.

Equal Opportunity & Diversity

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

Company Overview

We provide access to high-quality healthcare, innovative programs and a wide range of health solutions that help families and individuals get well, stay well and be well.