Centene Corporation Psychologist Reviewer in Detroit, Michigan
This is a remote position.
Authorize, direct and monitor care for mental 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 for outpatient and 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 level clinician.
Facilitate outpatient rounds offering clinical input and oversight related to outpatient services.
Doctorate degree in Clinical Psychology, Counseling or related field. 5+ years of psychiatric and/or substance abuse experience (including utilization review), preferably in a health care setting. Working knowledge of psychological tests and testing procedures, diagnostic evaluations and evidence based practices.
Unrestricted license as a Psychologist (PhD or PsyD); BCBA certification required for Behavioral Health roles.
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.
TITLE: Psychologist Reviewer
LOCATION: Detroit, Michigan
COMPANY: Clinical & Care Management
POSITION TYPE: Both
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