[Hiring] Psychologist Reviewer @Elevance Health

Role Description

The Psychologist Reviewer – ABA is responsible for collaborating with providers, BCBAs, and Medical Directors to determine appropriateness of level of care based on Medical Necessity Criteria. Outpatient levels of care would primarily include Applied Behavior Analysis (ABA). Other levels of care could include Psychological Testing, Neuropsychological Testing, and Mental Health Support Services.

• Partners with internal UR staff and external Behavioral Health Providers to ensure appropriate and consistent utilization of plan benefits, out of network services, and clinical guidelines within scope of license.
• Conducts pre-certification, concurrent review, and appeals of Behavioral Health OP services.
• Mentors Behavioral Health Care Management staff by assisting in training, attending utilization management rounds, and serving on interdepartmental initiatives; assists in developing a program around psychological and neuropsychological testing.

Qualifications

• Requires Ph.D. or Psy.D in clinical/counseling psychology and managed care experience which includes experience with the administration and interpretation of psychological test batteries; or any combination of education and experience, which would provide an equivalent background.
• Must possess an active unrestricted license to practice as Clinical/Counseling Psychologist.

Requirements

• Minimum of 2 years experience in a Behavioral Health/Clinical setting preferred.
• BCBA-D is strongly preferred.
• Previous experience working alongside an ABA clinician or in collaboration/partnership with ABA services.
• Qualified candidates in alternate locations outside of posting locations are welcome to apply.

Benefits

• Comprehensive benefits package.
• Incentive and recognition programs.
• Equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements).