Psychologist Reviewer (Apply in minutes)
Sunshine State Health Plan Miami Gardens Full-time
You could be the one who changes everything for our 28 million members as a
clinical professional on our Medical ManagementHealth Services team. Centene
is a diversified, national organization offering competitive benefits
and substance abuse problems according to clinical information given by
providers and internal criteria for medical necessity and appropriateness of
care
PhD Clinical Psychology, Counseling, Behavior Analysis, or related field is
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
individuals skills, experience, education, and other job-related factors
permitted by law. Total compensation may also include additional forms of
clinical professional on our Medical ManagementHealth Services team. Centene
is a diversified, national organization offering competitive benefits
including a fresh perspective on workplace flexibility.
**Position Purpose:** Authorize, direct and monitor care for behavioral healthand 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 therapistcertified Behavior Analyst for outpatient andor 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 PhDPsyD
- Facilitate outpatient rounds offering clinical input and oversight related to outpatient services
- Performs other duties as assigned
- Complies with all policies and standards
PhD Clinical Psychology, Counseling, Behavior Analysis, or related field is
required**.**
2+ years Behavioral Health is required.
Working knowledge of psychological tests and testing procedures, diagnosticevaluations and evidence based practices is required.
PSY - Psychologist Unrestricted License (PhD or PsyD) upon hire is required orBoard Certified Behavior Analyst (BCBA)
Pay Range: $84,300.00 - $151,700.00 per year
Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paidtime 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
individuals skills, experience, education, and other job-related factors
permitted by law. Total compensation may also include additional forms of
incentives.
Centene is an equal opportunity employer that is committed to diversity, andvalues 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, veteranstatus, or other characteristic protected by applicable law.
Qualified applicants with arrest or conviction records will be considered inaccordance with the LA County Ordinance and the California Fair Chance Act
Sunshine State Health PlanMiami Gardens
and appropriateness of
care
• Conduct peer reviews with psychologist and licensed therapistcertified Behavior Analyst for outpatient andor psychological testing requests
• Interact with network practitioners to provide education on best practice models...
Sunshine State Health PlanHialeah, 5 mi from Miami Gardens
and appropriateness of
care
• Conduct peer reviews with psychologist and licensed therapistcertified Behavior Analyst for outpatient andor psychological testing requests
• Interact with network practitioners to provide education on best practice models...
Sunshine State Health PlanHialeah, 5 mi from Miami Gardens
and appropriateness of
care
• Conduct peer reviews with psychologist and licensed therapistcertified Behavior Analyst for outpatient andor psychological testing requests
• Interact with network practitioners to provide education on best practice models...