Psychologist Reviewer

Centene Corporation; Kentucky; Remote; USD 90,000 - 120,000; Full time

Benefits offered by this job

Remote work

Job summary

Centene Corporation is seeking a Remote Psychologist Reviewer specialized in Applied Behavior Analysis (ABA) and autism care. You will authorize, direct, and monitor care based on clinical information and medical necessity criteria, collaborating with providers and the Medical Director as needed.

The role requires an active psychologist license in KY (and other states as applicable) and a PhD/PsyD. BCBA certification is preferred; the work offers remote engagement with opportunities to impact

Qualifications

• PhD/PsyD in clinical psychology, counseling, behavior analysis, or related field.
• Minimum 2 years of behavioral health experience.
• Working knowledge of psychological tests, evaluations and evidence-based practices.

Responsibilities

• Conduct peer reviews with psychologists, behavioral health therapists and/or BCBA-DS for outpatient services and/or psychological testing requests.
• Interact with network practitioners to educate on best practice models and utilization management processes.
• Interact with the Medical Director, or designee, to discuss clinical authorization questions and concerns.
• Respond to state, provider, and member complaints related to testing or services requiring review.
• Facilitate outpatient rounds offering clinical input and oversight related to outpatient services.
• Perform other duties as assigned.
• Complies with all policies and standards.

Skills

Peer review coordination

Behavioral Health

Utilization management

ABA knowledge

Education

PhD in Clinical Psychology

2+ years Behavioral Health experience

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.

• 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:

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