Psychologist Reviewer

Role Overview

• 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.

Requirements

• 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
• PSY
• Psychologist Unrestricted License (PhD or PsyD) Upon Hire required
• Board Certified Behavior Analyst (BCBA) BCBA-D Upon Hire preferred

Benefits

• competitive pay
• health insurance
• 401K and stock purchase plans
• tuition reimbursement
• paid time off plus holidays
• flexible approach to work with remote, hybrid, field or office work schedules