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Psychologist Reviewer

Company: Centene
Location: Lawton
Posted on: February 9, 2024

Job Description:

You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility.

Oklahoma Complete Health, a Centene company, is committed to providing quality healthcare solutions to transform the health of Oklahomans.

At Oklahoma Complete Health, we are community advocates and change-makers in search of an inclusive culture grounded by our commitment to work-life balance, competitive compensation, and continuous career development. Join us and be a part of a collaborative, growing network of innovative thinkers delivering solutions at the local level.

Position Purpose: 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
          • Performs other duties as assigned
            • Complies with all policies and standardsEducation/Experience:
              Education/Experience: A doctorate degree in Clinical Psychology, Counseling, Behavior Analysis, or related field. 5+ experience years in Behavioral Health. Working knowledge of psychological tests and testing procedures, diagnostic evaluations and evidence based practices.

              License/Certification: Unrestricted license as a Psychologist (PhD or PsyD) or Board Certified Behavior Analyst-Doctoral (BCBA-D).Pay Range: $82,600.00 - $148,700.00 per year
              Our Comprehensive Benefits Package: Flexible work solutions including remote options, hybrid work schedules and dress flexibility, Competitive pay, Paid time off including holidays, Health insurance coverage for you and your dependents, 401(k) and stock purchase plans, Tuition reimbursement and best-in-class training and development.

              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. Total compensation may also include additional forms of incentives.

Keywords: Centene, Lawton , Psychologist Reviewer, Healthcare , Lawton, Oklahoma

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