4,026 Freelance Reviewer jobs in the United States
Quality Assurance Batch Record Reviewer
Posted today
Job Viewed
Job Description
Quality Assurance Batch Record Reviewer – Newtown, PA
Responsible for performing tasks to specifications related to oral solid and liquid dose pharmaceutical packaging. Processes include reviewing of batch records for the packaging department. Author the Quality Assurance related procedures and process them through Master Control. When required, provide assistance in deviation related activity.
- Key duties and Responsibilities Review the completed batch records for packaging.
- Serve as backup for review of packaging documents when required.
- Ensure the batch records have the proper signature, documentation and completed entries.
- Review to ensure accurate completion of equipment logs.
- Ensure all batch records are accounted for and transferred to the QA department.
- Ensure all entries are entered into the computer system.
- Identify and report quality issues to management.
- Report accidents, unsafe conditions or unusual circumstances to supervisor.
- Adhere to all relevant cGMP and FDA regulations.
- Maintaining a neat and orderly work area at all times
- Provide a support to Investigation team as and when needed.
- Other duties, which may be assigned from time to time, by management of the company
- Comply with FDA guidelines/Company Policies of Data Integrity
- Prepare, review and approve Standard Operating Procedures in Master Control.
- Education and Experience High school diploma or equivalent preferred ‘
- 1+ year of previous experience in a similar position
- Ability to read and comprehend documents such as batch records, packaging instructions, SOPs and training materials.
- Proficient communication skills, both verbal and written.
- Computer experience with basic programs preferred.
Senior Quality Assurance Technical Reviewer
Posted 2 days ago
Job Viewed
Job Description
**Position Summary**
Catalent, Inc. is a leading global contract development and manufacturing organization (CDMO) whose mission is to develop, manufacture, and supply products that help people live better and healthier lives. Catalent is dedicated to delivering unparalleled service to pharma, biotech, and consumer health customers, supporting product development, launch, and full life-cycle supply. With time-tested experience in development sciences, delivery technologies, and multi-modality manufacturing, Catalent supports the acceleration of development programs and the launch of more than a hundred new products every year. Powered by thousands of scientists and technicians and the latest technology platforms at more than 40 global sites, Catalent supplies billions of doses of life-enhancing and life-saving treatments for patients annually.
St. Petersburg is our primary soft gel development and manufacturing facility in North America with capacity of 18 billion capsules per year. Within the Catalent network, we offer a broad range of integrated formulation and analytical services to solve difficult development and manufacturing challenges.
Catalent is committed to a Patient First culture through excellence in quality and compliance, and to the safety of every patient, consumer and Catalent employee.
This position is responsible for the overall Quality Assurance review of all technical documents, as they relate to a) process improvement projects; b) all equipment IQ/OQ/PQ documents regarding equipment, utilities, and computer systems; c) all product process validation and cleaning validation documents; d) all Preventive Maintenance and Calibration work order requirements for critical systems e) Deviation and complaint investigation reports. Furthermore, this position will participate in the internal audit program as well as customer audits.
This position is 100% on-site at the St. Petersburg site.
**The Role**
+ Provide QA Technical support during the development and manufacturing improvements throughout the design phase, technical transfers and routine production.
+ Ability to investigate and analyze technical reports and technical concerns to determine trends affecting future designs, production activities.
+ Provide QA Technical recommendations based on trend analysis to eliminate future problems.
+ Participates in various project meetings to provide Quality Assurance input with respect to compliance to cGMP requirements.
+ Reviews and approves technical documents, such as: Technical Protocols and Reports, Process
+ Validation Protocols and Reports, Cleaning Validation Protocols and Reports, IQ/OQ/PQ Protocols and Reports and, Change Control, as it pertains to the above validated/qualified systems.
+ Reviews and approves deviation investigations with particular attention to suggested root cause and CAPA to ensure appropriate actions are identified to prevent occurrence/reoccurrence
+ Provides feedback to the appropriate department (i.e. regarding the compliance and adequacy of the documents reviewed as it pertains to cGMPs, site SOPs and regulatory guidelines).
+ Other duties as assigned.
**The Candidate**
+ Bachelor's degree in Science or Engineering with minimum of 3 years of related experience in QA pharmaceutical manufacturing and/or Manufacturing pharmaceutical operation.
+ Prior experience working with technical review, investigation writing, including root cause analysis and report writing is a must.
+ Proficient to Advance knowledge of Microsoft programs required (Excel, Word, Access and PowerPoint). Experience with Documentum, TrackWise, and JD Edwards is preferred.
+ Proficient (excellent) English verbal and written communication skills to communicate with all levels of the organization in various functional areas and receive ideas and instructions to/from others within and outside the organization and effectively present information and respond to questions from site management.
+ Ability to work in a cross-functional team environment.
+ Proven ability to multi-task and demonstrate diplomatic skills.
+ Must possess solid technical expertise as it relates to manufacturing processes, decision-making skills, and the ability to solve problems with minimal guidance.
+ Ability to identify root cause of problems and offer solutions, which address causes, rather than
+ symptoms.
+ Working knowledge of cGMPs and/or OSHA regulations required.
+ Ability to work effectively under pressure to meet deadlines. Individual required to sit, stand, walk and lift 0-15 pounds; no lifting greater than 44.09 pounds without assistance. Be accessible to manufacturing floor and office staff and to use required office equipment. Specific vision requirements include reading of written documents and use of computer monitor screen frequently.
**Why You Should Join Catalent**
+ Competitive medical benefits and 401K
+ 152 hours of PTO + 8 Paid Holidays
+ Dynamic, fast-paced work environment
+ Opportunity to work on Continuous Improvement Processes
**Catalent offers rewarding opportunities to further your career!** Join the global drug development and delivery leader and help us bring over 7,000 life-saving and life-enhancing products to patients around the world. Catalent is an exciting and growing international company where employees work directly with pharma, biopharma and consumer health companies of all sizes to advance new medicines from early development to clinical trials and to the market. Catalent produces more than 70 billion doses per year, and each one will be used by someone who is counting on us. Join us in making a difference.
personal initiative. dynamic pace. meaningful work.
Visit Catalent Careers ( to explore career opportunities.
Catalent is an Equal Opportunity Employer, including disability and veterans.
If you require reasonable accommodation for any part of the application or hiring process due to a disability, you may submit your request by sending an email, and confirming your request for an accommodation and include the job number, title and location to . This option is reserved for individuals who require accommodation due to a disability. Information received will be processed by a U.S. Catalent employee and then routed to a local recruiter who will provide assistance to ensure appropriate consideration in the application or hiring process.
Notice to Agency and Search Firm Representatives: Catalent Pharma Solutions (Catalent) is not accepting unsolicited resumes from agencies and/or search firms for this job posting. Resumes submitted to any Catalent employee by a third party agency and/or search firm without a valid written & signed search agreement, will become the sole property of Catalent. No fee will be paid if a candidate is hired for this position as a result of an unsolicited agency or search firm referral. Thank you.
Important Security Notice to U.S. Job Seekers:
Catalent NEVER asks candidates to provide any type of payment, bank details, photocopies of identification, social security number or other highly sensitive personal information during the offer process, and we NEVER do so via email or social media. If you receive any such request, DO NOT respond- it is a fraudulent request. Please forward such requests to for us to investigate with local authorities.
California Job Seekers can find our California Job Applicant Notice HERE ( .
Quality Assurance Batch Record Reviewer
Posted today
Job Viewed
Job Description
Quality Assurance Batch Record Reviewer – Newtown, PA
Responsible for performing tasks to specifications related to oral solid and liquid dose pharmaceutical packaging. Processes include reviewing of batch records for the packaging department. Author the Quality Assurance related procedures and process them through Master Control. When required, provide assistance in deviation related activity.
- Key duties and ResponsibilitiesReview the completed batch records for packaging.
- Serve as backup for review of packaging documents when required.
- Ensure the batch records have the proper signature, documentation and completed entries.
- Review to ensure accurate completion of equipment logs.
- Ensure all batch records are accounted for and transferred to the QA department.
- Ensure all entries are entered into the computer system.
- Identify and report quality issues to management.
- Report accidents, unsafe conditions or unusual circumstances to supervisor.
- Adhere to all relevant cGMP and FDA regulations.
- Maintaining a neat and orderly work area at all times
- Provide a support to Investigation team as and when needed.
- Other duties, which may be assigned from time to time, by management of the company
- Comply with FDA guidelines/Company Policies of Data Integrity
- Prepare, review and approve Standard Operating Procedures in Master Control.
- Education and ExperienceHigh school diploma or equivalent preferred ‘
- 1+ year of previous experience in a similar position
- Ability to read and comprehend documents such as batch records, packaging instructions, SOPs and training materials.
- Proficient communication skills, both verbal and written.
- Computer experience with basic programs preferred.
Quality Assurance Batch Record Reviewer (Newtown)
Posted 1 day ago
Job Viewed
Job Description
Quality Assurance Batch Record Reviewer Newtown, PA
Responsible for performing tasks to specifications related to oral solid and liquid dose pharmaceutical packaging. Processes include reviewing of batch records for the packaging department. Author the Quality Assurance related procedures and process them through Master Control. When required, provide assistance in deviation related activity.
- Key duties and Responsibilities Review the completed batch records for packaging.
- Serve as backup for review of packaging documents when required.
- Ensure the batch records have the proper signature, documentation and completed entries.
- Review to ensure accurate completion of equipment logs.
- Ensure all batch records are accounted for and transferred to the QA department.
- Ensure all entries are entered into the computer system.
- Identify and report quality issues to management.
- Report accidents, unsafe conditions or unusual circumstances to supervisor.
- Adhere to all relevant cGMP and FDA regulations.
- Maintaining a neat and orderly work area at all times
- Provide a support to Investigation team as and when needed.
- Other duties, which may be assigned from time to time, by management of the company
- Comply with FDA guidelines/Company Policies of Data Integrity
- Prepare, review and approve Standard Operating Procedures in Master Control.
- Education and Experience High school diploma or equivalent preferred
- 1+ year of previous experience in a similar position
- Ability to read and comprehend documents such as batch records, packaging instructions, SOPs and training materials.
- Proficient communication skills, both verbal and written.
- Computer experience with basic programs preferred.
Nurse Reviewer
Posted today
Job Viewed
Job Description
This position will audit, inspect, and train MassHealth providers and integrated care plans as well as provide clinical support to OLTSS staff who manage those programs. Additionally, the nurse will provide input on cross-cutting clinical initiatives affecting LTSS programs. This work will require close collaboration with OLTSS program teams and other units within MassHealth, such as Clinical Affairs, as well as MassHealth LTSS Third Party Administrator. The incumbent will report to OLTSS' Clinical Lead, Community and Integrated Care Programs.
Duties and Responsibilities (these duties are a general summary and not all inclusive):
Conducting site and desk audits of LTSS providers and integrated care plans to evaluate quality of care, medical necessity, program eligibility, health and safety, care planning, clinical documentation, staffing, and compliance with MassHealth regulations
Visiting member homes in order to observe care, interview providers and MassHealth members and their caregivers, and review clinical documentation
Providing training, coaching, and other feedback to LTSS providers and integrated care plans based on audit results, MassHealth regulations, clinical best practices, and other OLTSS program needs
Providing clinical support to OLTSS program teams in the day-to-day management of their programs, in the form of reviewing critical incident reports, advising on quality improvement and performance measurement initiatives, responding to providers on clinical issues, assisting with hard-to-place MassHealth members, and advising on clinical impact of changes to regulations and medical necessity criteria.
Reviewing clinical evaluations and eligibility determinations submitted by providers and plans for purposes of confirming eligibility
Serving as clinical subject matter expert on strategic projects, such as the Uniform Core Assessment, development of key performance indicators, or other projects as assigned.
Working with fellow Nurse Reviewers, OLTSS program staff, and the OLTSS Senior Medical Director to identify key clinical problems facing OLTSS programs and offer solutions and recommendations
Evaluating the quality of clinical work conducted by MassHealth's LTSS Third Party Administrator, such as prior authorizations and clinical audits, as well as clinical work conducted by other MassHealth contractors
Documenting audits and reviews using audit tools and standard operating procedures and professional standards and best practices
Preferred Qualifications:
General knowledge of the MassHealth program, including mission, overall structure, benefits, eligibility, payment methodologies, and trends
Specific knowledge of MassHealth long term care programs, including eligibility, provider types, and trends
Knowledge of Geriatric and disability nursing
Ability to translate clinical issues to program staff, providers and plans, advocates
Experience training and coaching health care practitioners
Excellent documentation, presentation, facilitation, and communication skills.
A strong ability to build relationships with internal and external stakeholders and possess the ability to quickly learn their needs
Experience conducting clinical assessments and utilization review
Ability to fill out electronic surveys and assessments in Microsoft Forms, online tools, etc.
Experience overseeing or providing clinical care for an LTSS program or provider
Understanding of the managed health care environment
Strong analytical skills.
Experience working with cross-functional areas and teams.
Experience using Microsoft suite (Excel, Access, Word, and Microsoft project).
Special Requirements:
Licensed Registered Nurse
TO APPLY:
Please upload both Resume and Cover Letter for this position when applying. First consideration will be given to those applicants that apply within the first 14 days.
About MassHealth:
The mission of MassHealth is to improve the health outcomes of our diverse members, their families, and their communities by providing access to integrated health care services that sustainably promote health, well-being, independence, and quality of life.
For more information about our agency and programs please visit:
Pre-Offer Process:
A criminal background check will be completed on the recommended candidate as required by the regulations set forth by the Executive Office of Health and Human Services prior to the candidate being hired. For more information, please visit
Education, licensure and certifications will be verified in accordance with the Human Resources Division's Hiring Guidelines.
Education and license/certification information provided by the selected candidate(s) is subject to the Massachusetts Public Records Law and may be published on the Commonwealth's website.
If you require assistance with the application/interview process and would like to request an ADA accommodation, please click on the link and complete the ADA Reasonable Accommodation Request Form .
For questions regarding this requisition, please the contact the Executive Office of Health and Human Services Human Resources at and select option #4.
Applicants should upload a cover letter and resume for the Nurse Reviewer requisition.
Qualifications:
First consideration will be given to those applicants that apply within the first 14 days.
MINIMUM ENTRANCE REQUIREMENTS:
Applicants must have at least (A) one year of full-time or equivalent part-time, experience as a registered nurse in a recognized hospital, clinic or medical facility, and (B) six months of which must have been in a supervisory, administrative or managerial capacity.
SPECIAL REQUIREMENTS FOR ALL LEVELS IN SERIES: Current and valid registration as a professional nurse under the Massachusetts Board of Registration in Nursing.*
*Recent graduates from an approved school of nursing must have applied for the first available registered nurse examination.
Based on assignment, possession of a current and valid Massachusetts Motor Vehicle Operator's license may be required.
Salary placement is determined by a combination of factors, including the candidate's years of directly related experience and education, and alignment with our internal compensation structure as set forth by the Human Resources Division's Hiring Guidelines. For all bargaining unit positions (non-management), compensation is subject to the salary provisions outlined in the applicable collective bargaining agreement and will apply to placement within the appropriate salary range .
Comprehensive Benefits
When you embark on a career with the Commonwealth, you are offered an outstanding suite of employee benefits that add to the overall value of your compensation package. We take pride in providing a work experience that supports you, your loved ones, and your future.
Want the specifics? Explore our Employee Benefits and Rewards!
An Equal Opportunity / Affirmative Action Employer. Females, minorities, veterans, and persons with disabilities are strongly encouraged to apply.
The Commonwealth is an Equal Opportunity Employer and does not discriminate on the basis of race, religion, color, sex, gender identity or expression, sexual orientation, age, disability, national origin, veteran status, or any other basis covered by appropriate law. Research suggests that qualified women, Black, Indigenous, and Persons of Color (BIPOC) may self-select out of opportunities if they don't meet 100% of the job requirements. We encourage individuals who believe they have the skills necessary to thrive to apply for this role.
Nurse Reviewer
Posted today
Job Viewed
Job Description
This position will audit, inspect, and train MassHealth providers and integrated care plans as well as provide clinical support to OLTSS staff who manage those programs. Additionally, the nurse will provide input on cross-cutting clinical initiatives affecting LTSS programs. This work will require close collaboration with OLTSS program teams and other units within MassHealth, such as Clinical Affairs, as well as MassHealth LTSS Third Party Administrator. The incumbent will report to OLTSS' Clinical Lead, Community and Integrated Care Programs.
Duties and Responsibilities (these duties are a general summary and not all inclusive):
Conducting site and desk audits of LTSS providers and integrated care plans to evaluate quality of care, medical necessity, program eligibility, health and safety, care planning, clinical documentation, staffing, and compliance with MassHealth regulations
Visiting member homes in order to observe care, interview providers and MassHealth members and their caregivers, and review clinical documentation
Providing training, coaching, and other feedback to LTSS providers and integrated care plans based on audit results, MassHealth regulations, clinical best practices, and other OLTSS program needs
Providing clinical support to OLTSS program teams in the day-to-day management of their programs, in the form of reviewing critical incident reports, advising on quality improvement and performance measurement initiatives, responding to providers on clinical issues, assisting with hard-to-place MassHealth members, and advising on clinical impact of changes to regulations and medical necessity criteria.
Reviewing clinical evaluations and eligibility determinations submitted by providers and plans for purposes of confirming eligibility
Serving as clinical subject matter expert on strategic projects, such as the Uniform Core Assessment, development of key performance indicators, or other projects as assigned.
Working with fellow Nurse Reviewers, OLTSS program staff, and the OLTSS Senior Medical Director to identify key clinical problems facing OLTSS programs and offer solutions and recommendations
Evaluating the quality of clinical work conducted by MassHealth's LTSS Third Party Administrator, such as prior authorizations and clinical audits, as well as clinical work conducted by other MassHealth contractors
Documenting audits and reviews using audit tools and standard operating procedures and professional standards and best practices
Preferred Qualifications:
General knowledge of the MassHealth program, including mission, overall structure, benefits, eligibility, payment methodologies, and trends
Specific knowledge of MassHealth long term care programs, including eligibility, provider types, and trends
Knowledge of Geriatric and disability nursing
Ability to translate clinical issues to program staff, providers and plans, advocates
Experience training and coaching health care practitioners
Excellent documentation, presentation, facilitation, and communication skills.
A strong ability to build relationships with internal and external stakeholders and possess the ability to quickly learn their needs
Experience conducting clinical assessments and utilization review
Ability to fill out electronic surveys and assessments in Microsoft Forms, online tools, etc.
Experience overseeing or providing clinical care for an LTSS program or provider
Understanding of the managed health care environment
Strong analytical skills.
Experience working with cross-functional areas and teams.
Experience using Microsoft suite (Excel, Access, Word, and Microsoft project).
Special Requirements:
Licensed Registered Nurse
TO APPLY:
Please upload both Resume and Cover Letter for this position when applying. First consideration will be given to those applicants that apply within the first 14 days.
About MassHealth:
The mission of MassHealth is to improve the health outcomes of our diverse members, their families, and their communities by providing access to integrated health care services that sustainably promote health, well-being, independence, and quality of life.
For more information about our agency and programs please visit: Process:
A criminal background check will be completed on the recommended candidate as required by the regulations set forth by the Executive Office of Health and Human Services prior to the candidate being hired. For more information, please visit licensure and certifications will be verified in accordance with the Human Resources Division's Hiring Guidelines.
Education and license/certification information provided by the selected candidate(s) is subject to the Massachusetts Public Records Law and may be published on the Commonwealth's website.
If you require assistance with the application/interview process and would like to request an ADA accommodation, please click on the link and complete the ADA Reasonable Accommodation Request Form.
For questions regarding this requisition, please the contact the Executive Office of Health and Human Services Human Resources at and select option #4.
Applicants should upload a cover letter and resume for the Nurse Reviewer requisition.
First consideration will be given to those applicants that apply within the first 14 days.
MINIMUM ENTRANCE REQUIREMENTS:
Applicants must have at least (A) one year of full-time or equivalent part-time, experience as a registered nurse in a recognized hospital, clinic or medical facility, and (B) six months of which must have been in a supervisory, administrative or managerial capacity.
SPECIAL REQUIREMENTS FOR ALL LEVELS IN SERIES: Current and valid registration as a professional nurse under the Massachusetts Board of Registration in Nursing.*
* Recent graduates from an approved school of nursing must have applied for the first available registered nurse examination.
Based on assignment, possession of a current and valid Massachusetts Motor Vehicle Operator's license may be required.
Salary placement is determined by a combination of factors, including the candidate's years of directly related experience and education, and alignment with our internal compensation structure as set forth by the Human Resources Division's Hiring Guidelines. For all bargaining unit positions (non-management), compensation is subject to the salary provisions outlined in the applicable collective bargaining agreement and will apply to placement within the appropriate salary range.
Comprehensive Benefits
When you embark on a career with the Commonwealth, you are offered an outstanding suite of employee benefits that add to the overall value of your compensation package. We take pride in providing a work experience that supports you, your loved ones, and your future.
Want the specifics? Explore our Employee Benefits and Rewards!
An Equal Opportunity / Affirmative Action Employer. Females, minorities, veterans, and persons with disabilities are strongly encouraged to apply.
The Commonwealth is an Equal Opportunity Employer and does not discriminate on the basis of race, religion, color, sex, gender identity or expression, sexual orientation, age, disability, national origin, veteran status, or any other basis covered by appropriate law. Research suggests that qualified women, Black, Indigenous, and Persons of Color (BIPOC) may self-select out of opportunities if they don't meet 100% of the job requirements. We encourage individuals who believe they have the skills necessary to thrive to apply for this role.
Psychologist Reviewer
Posted 3 days ago
Job Viewed
Job Description
You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility. Centene is hiring a Remote Psychologist – Join Our Kentucky Medicaid Team! Are you a licensed Psychologist with a Kentucky license with a passion for improving access to behavioral health care? Centene is looking for a Remote Psychologist to support our Kentucky Medicaid plan. In this role, you’ll play a key part in outpatient and psych/neuro psych testing note reviews, appeals, and occasional peer-to-peer consultations, as well as participating in Utilization Management clinical rounds. We’re seeking candidates who: Hold an active Kentucky Psychologist license Are familiar with Medicaid guidelines, prior authorization, and telehealth practices Thrive in a collaborative, remote work environment This is a great opportunity to apply your clinical expertise in a non-direct care role, supporting quality care and outcomes for the Medicaid population. 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 Education/Experience: PhD Clinical Psychology, Counseling, Behavior Analysis, or related field required: 2 years 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) Upon Hire required or: Board Certified Behavior Analyst (BCBA) BCBA-D Upon Hire required: Pay Range: $86,000.00 - $154,700.00 per year Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid 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 individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility. 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. Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act
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Psychologist Reviewer
Posted 3 days ago
Job Viewed
Job Description
You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility. Centene is hiring a Remote Psychologist – Join Our Kentucky Medicaid Team! Are you a licensed Psychologist with a Kentucky license with a passion for improving access to behavioral health care? Centene is looking for a Remote Psychologist to support our Kentucky Medicaid plan. In this role, you’ll play a key part in outpatient and psych/neuro psych testing note reviews, appeals, and occasional peer-to-peer consultations, as well as participating in Utilization Management clinical rounds. We’re seeking candidates who: Hold an active Kentucky Psychologist license Are familiar with Medicaid guidelines, prior authorization, and telehealth practices Thrive in a collaborative, remote work environment This is a great opportunity to apply your clinical expertise in a non-direct care role, supporting quality care and outcomes for the Medicaid population. 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 Education/Experience: PhD Clinical Psychology, Counseling, Behavior Analysis, or related field required: 2 years 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) Upon Hire required or: Board Certified Behavior Analyst (BCBA) BCBA-D Upon Hire required: Pay Range: $86,000.00 - $154,700.00 per year Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid 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 individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility. 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. Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act
Psychologist Reviewer
Posted 3 days ago
Job Viewed
Job Description
You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility. Remote Opportunity Centene is Hiring – Remote Psychologist Reviewer (ABA) Centene is seeking a Remote Psychologist Reviewer specializing in Applied Behavior Analysis (ABA). An ideal candidate will hold an active psychologist license and have a BCBA-D, with eligibility and willingness to apply for an Indiana license. Join Centene’s mission-driven team and make a meaningful impact on the lives of individuals with Autism. We are seeking a dedicated professional who is passionate about delivering high-quality, evidence-based behavioral health care. The ideal candidate will hold both a psychologist license and BCBA certification to support our growing markets and ensure clinical excellence. Why Join Us? · 100% remote flexibility · Meaningful work improving care for youth with Autism · Collaborative, supportive team environment Position Purpose: Authorize, direct and monitor care for behavioral health and/or substance abuse problems according to clinical information given by providers and internal criteria for medical necessity and appropriateness of care Conduct peer reviews with psychologists, behavioral health therapists and/or Board Certified Behavior Analysts for outpatient services 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. Education/Experience: PhD Clinical Psychology, Counseling, Behavior Analysis, or related field required : 2 years Behavioral Health required Working knowledge of psychological tests and testing procedures, diagnostic evaluations and evidence-based practices. required For ABA Reviewers only, working knowledge of psychological tests and testing procedures, diagnostic evaluations and evidence-based practices designed for individuals with Autism Spectrum Disorder. required Licenses/Certifications: PSY - Psychologist Unrestricted License (PhD or PsyD) Upon Hire required Board Certified Behavior Analyst (BCBA) BCBA-D Upon Hire preferred: Pay Range: $86,000.00 - $154,700.00 per year Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid 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 individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility. 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. Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act
Psychologist Reviewer
Posted 3 days ago
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Job Description
You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility. Remote Opportunity Centene is Hiring – Remote Psychologist Reviewer (ABA) Centene is seeking a Remote Psychologist Reviewer specializing in Applied Behavior Analysis (ABA). An ideal candidate will hold an active psychologist license and have a BCBA-D, with eligibility and willingness to apply for an Indiana license. Join Centene’s mission-driven team and make a meaningful impact on the lives of individuals with Autism. We are seeking a dedicated professional who is passionate about delivering high-quality, evidence-based behavioral health care. The ideal candidate will hold both a psychologist license and BCBA certification to support our growing markets and ensure clinical excellence. Why Join Us? · 100% remote flexibility · Meaningful work improving care for youth with Autism · Collaborative, supportive team environment Position Purpose: Authorize, direct and monitor care for behavioral health and/or substance abuse problems according to clinical information given by providers and internal criteria for medical necessity and appropriateness of care Conduct peer reviews with psychologists, behavioral health therapists and/or Board Certified Behavior Analysts for outpatient services 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. Education/Experience: PhD Clinical Psychology, Counseling, Behavior Analysis, or related field required : 2 years Behavioral Health required Working knowledge of psychological tests and testing procedures, diagnostic evaluations and evidence-based practices. required For ABA Reviewers only, working knowledge of psychological tests and testing procedures, diagnostic evaluations and evidence-based practices designed for individuals with Autism Spectrum Disorder. required Licenses/Certifications: PSY - Psychologist Unrestricted License (PhD or PsyD) Upon Hire required Board Certified Behavior Analyst (BCBA) BCBA-D Upon Hire preferred: Pay Range: $86,000.00 - $154,700.00 per year Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid 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 individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility. 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. Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act