Remote Psychologist Reviewer — ABA & Autism Care

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

Job summary

Centene Corporation is seeking a Remote Psychologist Reviewer to authorize, direct and monitor care for behavioral health and/or autism services, applying clinical information and medical necessity criteria. The role supports youth with evidence-based ABA programs and testing requests, working with networks and medical leadership.

Applicants must hold an active psychologist license (PhD/PsyD) in North Carolina or be willing to obtain licensure in other states; BCBA certification is preferred.

Qualifications

• PhD Clinical Psychology, Counseling, Behavior Analysis, or related field required
• 2+ years Behavioral Health required
• Working knowledge of psychological tests, testing procedures, and diagnostic evaluations

Responsibilities

• Conduct peer reviews with psychologists, behavioral health therapists and/or BCBA 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.

Skills

Clinical psychologist expertise

ABA knowledge

Education

PhD in Clinical Psychology or Counseling or Behavior Analysis

Job description

Centene Corporation is seeking a Remote Psychologist Reviewer to authorize, direct and monitor care for behavioral health and/or autism services, applying clinical information and medical necessity criteria. The role supports youth with evidence-based ABA programs and testing requests, working with networks and medical leadership.

Applicants must hold an active psychologist license (PhD/PsyD) in North Carolina or be willing to obtain licensure in other states; BCBA certification is preferred.