Psychologist Reviewer - ABA

About the role

This role enables associates to work virtually full-time, except for required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development.

Responsibilities

• Collaborates with providers and Medical Directors to determine appropriateness of level of care based on Medical Necessity Criteria.
• Outpatient levels of care include: Individual Therapy, Group Therapy, Family Therapy, Marriage/Couples Therapy, Psychological Testing, Neuropsychological Testing, Psychosocial Rehabilitation, Intensive Outpatient Treatment, Day Treatment, Mental Health Support Services, Applied Behavioral Analysis, and Autism Spectrum Disorder 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.

Requirements

• 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.

Preferred qualifications, skills, and experiences

• Minimum of 2 years experience in a Behavioral Health/Clinical setting preferred.
• Experience with Applied Behavioral Analysis and Autism Spectrum Disorder is strongly preferred.

Benefits

• A comprehensive benefits package.
• Incentive and recognition programs.
• Equity stock purchase.
• 401(k) contribution.

Pay

The salary range for this specific position is $93,120 to $167,616. Location(s): California; Cleveland, OH; Columbus, OH; New York; New Jersey.

Schedule

Standard Business Hours, 8am-5pm Monday - Friday.

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. Minimum of 2 years experience in a Behavioral Health/Clinical setting preferred. Experience with Applied Behavioral Analysis and Autism Spectrum Disorder is strongly preferred.

Contact Information

Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.