Psychologist Reviewer Job at Sunshine State Health Plan, Greensboro, NC

dlpOcWVRYnBOVmkwTkpkYUMvd0xjSnBiUVE9PQ==
  • Sunshine State Health Plan
  • Greensboro, NC

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.

***This position is fully remote with occasional travel for team meetings. Candidates must reside and be licensed in the State of Florida to be considered.***

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

  • 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
  • Experience working with children - 5+ years strongly preferred
  • Working knowledge of psychological tests and testing procedures, diagnostic evaluations and evidence-based practices. required
  • For ABA Reviewers only, working knowledge of psychological tests and testing procedures, diagnostic evaluations and evidence-based practices designed for individuals with Autism Spectrum Disorder required

Licenses/Certifications:
PSY - Psychologist Unrestricted License (PhD or PsyD) Upon Hire required
Board Certified Behavior Analyst (BCBA) BCBA-D Upon Hire preferred Pay Range: $86,000.00 - $154,700.00 per year

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

Job Tags

Full time, Part time, Work at office, Remote work, Flexible hours,

Similar Jobs

CenterWell Home Health

RN Clinical Manager, Home Health Job at CenterWell Home Health

 ...bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. Description of Benefits Humana, Inc. and its affiliated subsidiaries (collectively, Humana) offers competitive benefits that support whole-person well-being.... 

HireTalent

Assembler I Job at HireTalent

Must Have: Basic computer skill JOB DESCRIPTION Interviews will be conducted for this position. Our client Status accepted - this equates to Green Card/Permanent Resident Card - Work/employment Our client is not an acceptable proof. Possible extension... 

Analog Devices

Manufacturing Engineering Job at Analog Devices

 ...software technologies into solutions that help drive advancements in digitized factories, mobility, and digital healthcare, combat climate change, and reliably connect humans and the world. With revenue of more than $9 billion in FY24 and approximately 24,000 people... 

Pocketbook Agency

Personal Assistant to Founder Job at Pocketbook Agency

 ...Job Description JRN: 2237 We are seeking a professional, proactive, and detail-oriented Personal Assistant to support a Founder based in Miami, FL. This is a fully onsite role with occasional household-based overnights and weekend responsibilities. The ideal candidate... 

EBSCO Information Services

Medical Writer DynaMedex Job at EBSCO Information Services

 ...and recommendations with the quickest time-to-answer.Medical Writers drive the creation of DynaMedex content as part of a highly skilled...  ...experience is not required, if you have an interest in science and medicine, a willingness to learn, and a desire to work as part...