Psychologist Reviewer

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

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  Conduct peer reviews with psychologists, behavioral health therapists and/or Board Certified Behavior Analysts for outpatient services and/or psychological testing requests

  
  

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  Interact with network practitioners to provide education on best practice models and utilization management processes

  
  

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  Interact with the Medical Director, or designee, to discuss clinical authorization questions and concerns regarding specific cases

  
  

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  Respond to state, provider, and member complaints related to psychological testing or other services requiring review by a PhD/PsyD

  
  

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  Facilitate outpatient rounds offering clinical input and oversight related to outpatient services

  
  
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  Performs other duties as assigned.

  
  

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  Complies with all policies and standards.

  
  

Education/Experience:

PhD Clinical Psychology, Counseling, Behavior Analysis, or related field required

• 2+ years of clinical experience post licensure strongly preferred
• Experience working with children - 5+ years strongly preferred
• 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