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Psychologist Reviewer – Part Time
Elevance HealthPsychologist Reviewer assessing appropriateness of behavioral health care for ABA services. Collaborating with providers to enhance service delivery for Autism Spectrum Disorder.
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in Behavioral Health Management, including the administration and interpretation of psychological test batteries, while collaborating effectively with providers and stakeholders to enhance service delivery for Autism Spectrum Disorder. Holds an active license as a Clinical/Counseling Psychologist and possesses strong mentoring capabilities in a clinical setting.
Highest-signal resume keywords
Ph.D. Or Psy.D In Clinical/Counseling PsychologyActive Unrestricted License To Practice As Clinical/Counseling PsychologistManaged Care ExperienceExperience With Psychological Test BatteriesCollaboration With ABA Services
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Behavioral Health ManagementPsychological TestingNeuropsychological TestingUtilization ManagementPre-Certification ReviewConcurrent ReviewAppeals ProcessClinical GuidelinesService Delivery EnhancementTraining And Mentoring
Soft Skills
CollaborationMentoringCommunication
Industry Keywords
Medical Necessity CriteriaAutism Spectrum DisorderOutpatient ServicesIntensive Outpatient TreatmentPsychosocial RehabilitationMental Health Support ServicesBehavioral Health ProvidersClinical SettingUtilization ReviewInterdepartmental Initiatives
About the role
Key responsibilities & impact- Responsible for collaborating with providers and Medical Directors to determine appropriateness of level of care based on Medical Necessity Criteria
- May be called upon to review other outpatient levels of care including: Individual Therapy, Group Therapy, Family Therapy, Marriage/Couples Therapy, Psychological Testing, Neuropsychological Testing, Psychosocial Rehabilitation, Intensive Outpatient Treatment, Day Treatment, and Mental Health Support Services
- Serve as a subject matter expert collaborating with plan leadership, providers and other stakeholders to enhance the delivery of service for Autism Spectrum Disorder
- 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
What you’ll need- Requires Ph.D. or Psy.D in clinical/counseling psychology
- Managed care experience which includes experience with the administration and interpretation of psychological test batteries
- Active unrestricted license to practice as Clinical/Counseling Psychologist
- Minimum of 2 years experience in a Behavioral Health/Clinical setting preferred
- Previous experience working alongside an ABA clinician and/or in collaboration with ABA services is strongly preferred
Benefits
Comp & perks- paid holidays
- Paid Time Off
- incentive bonus programs
- medical benefits
- dental benefits
- vision benefits
- short and long term disability benefits
- 401(k) + match
- stock purchase plan
- life insurance
- wellness programs
- financial education resources