Psychologist Reviewer

Centene Corporation

. Authorize, direct, and monitor care for behavioral health and/or substance abuse problems according to provider clinical information and internal medical-necessity criteria .

Posted 10/22/2026full-timeRemote • North Carolina • United StatesJuniorMid-Level💰 $87,700 - $157,800 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in behavioral health care management, including clinical oversight, peer review processes, and compliance with medical necessity criteria. Holds a PhD or PsyD in Clinical Psychology or related field, with a strong foundation in psychological testing and evidence-based practices.

Highest-signal resume keywords

PhD In Clinical PsychologyBehavioral Health ExperiencePsychological Testing KnowledgeUnrestricted Psychologist LicenseBCBA Certification

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Clinical OversightPeer ReviewDiagnostic EvaluationsEvidence-Based PracticesUtilization Management

Soft Skills

Interpersonal CommunicationEducation and Training

Certifications & Qualifications

Unrestricted Psychologist LicenseBCBA Certification

Industry Keywords

Behavioral HealthSubstance AbuseAutism Spectrum DisorderMedical Necessity CriteriaOutpatient Services

About the role

Key responsibilities & impact

Authorize, direct, and monitor care for behavioral health and/or substance abuse problems according to provider clinical information and internal medical-necessity criteria
Conduct peer reviews with psychologists, behavioral health therapists, and/or Board Certified Behavior Analysts for outpatient services and psychological testing requests
Interact with network practitioners to provide education on best-practice models and utilization-management processes
Discuss clinical authorization questions and case concerns with the Medical Director or designee
Respond to state, provider, and member complaints related to psychological testing or other services requiring PhD/PsyD review
Facilitate outpatient rounds and provide clinical input and oversight for outpatient services
Comply with all policies and standards
Perform other duties as assigned

Requirements

What you’ll need

PhD in Clinical Psychology, Counseling, Behavior Analysis, or related field required
2+ years of Behavioral Health experience required
Working knowledge of psychological tests and testing procedures, diagnostic evaluations, and evidence-based practices required
For ABA Reviewers, working knowledge of psychological tests and testing procedures, diagnostic evaluations, and evidence-based practices designed for individuals with Autism Spectrum Disorder required
Unrestricted Psychologist License (PhD or PsyD) required upon hire
Active psychologist license in Arkansas, Kentucky, North Carolina, or New Jersey
Licenses in other states may be considered if the candidate is willing and able to obtain additional required licensure
BCBA certification preferred

Benefits

Comp & perks

Health insurance
401K plan
Stock purchase plan
Tuition reimbursement
Paid time off
Paid holidays
Flexible approach to remote, hybrid, field, or office work schedules
Additional forms of incentives may be included in total compensation
Equal opportunity employer committed to diversity