Psychologist Reviewer
Centene
- Baton Rouge, LA
- $84,300-151,700 per year
- Permanent
- Full-time
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 standards