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

• Behavioral Health Experience: Minimum of 2 years required.
• Post-Licensure Clinical Experience: At least 2 years strongly preferred.
• Pediatric Experience: 5+ years working with children strongly preferred.
• Clinical Knowledge:
  
  
  
  • Required: Working knowledge of psychological tests, testing procedures, diagnostic evaluations, and evidence-based practices.
  • For ABA Reviewers only: Must have working knowledge of psychological assessments, diagnostic tools, and evidence-based practices specifically designed for individuals with Autism Spectrum Disorder (ASD).
  
  
  
  

Licenses/Certifications:

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

Client 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.