Psychologist Reviewer - ABA
Core
Reviewing behavioral health services to determine medical necessity and appropriateness of care levels for members.
Role type
Licensed clinical psychologist (utilization management)
Builds
Utilization management decisions for outpatient behavioral health services
Domain
Healthcare / Behavioral Health
Deliverable
client delivery
Required skills
[Ph.D. or Psy.D in clinical/counseling psychology], [active unrestricted license to practice as Clinical/Counseling Psychologist], [experience administering and interpreting psychological test batteries], [managed care experience]
Preferred skills
[2+ years in Behavioral Health/Clinical setting], [experience with Applied Behavioral Analysis], [experience with Autism Spectrum Disorder]
Technologies
[psychological test batteries]
Responsibilities
[Partners with UR staff and providers to ensure appropriate utilization of plan benefits], [Conducts pre-certification, concurrent review, and appeals of Behavioral Health OP services], [Mentors Behavioral Health Care Management staff and assists in developing testing programs]
Seniority
Mid-level, licensed professional