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Clinical Professional

2 months ago

Stillwater, Oklahoma, United States Centene Full time
Job Summary

Centene is seeking a highly skilled Clinical Professional to join our Medical Management/Health Services team. As a clinical reviewer, you will play a critical role in authorizing and directing care for behavioral health and substance abuse problems.

Key Responsibilities
  • Conduct peer reviews with psychologists and licensed therapists/certified behavior analysts for outpatient and/or psychological testing requests.
  • Interact with network practitioners to provide education on best practice models and utilization management processes.
  • Collaborate with the Medical Director 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.
  • Perform other duties as assigned.
  • Comply with all policies and standards.
Requirements
  • PhD in Clinical Psychology, Counseling, Behavior Analysis, or related field required.
  • 2+ years of experience in behavioral health required.
  • Working knowledge of psychological tests and testing procedures, diagnostic evaluations, and evidence-based practices required.
  • PSY - Psychologist Unrestricted License (PhD or PsyD) or Board Certified Behavior Analyst (BCBA) BCBA-D required.
What We Offer
  • Competitive pay: $84,151,700.00 per year.
  • Comprehensive benefits package, including health insurance, 401K, and stock purchase plans.
  • Tuition reimbursement and paid time off plus holidays.
  • Flexible work arrangements, including remote, hybrid, field, or office work schedules.