Clinical Psychologist - BCBA-D
Core
Principal utilization management reviewer for ABA and neuropsychological testing cases, providing clinical expertise to manage care and review claims for members with neurodevelopmental disorders.
Role type
Senior IC clinical psychologist (utilization management)
Builds
Medical management programs, policies, and review guidelines for neurodevelopmental disorders
Domain
Health insurance / Behavioral health / Autism Spectrum Disorder
Deliverable
dashboards & analysis
Required skills
ABA treatment, neuropsychological testing, neurodevelopmental disorders assessment, fraud waste and abuse review, CPT/HCPCS coding, Medicaid program knowledge
Preferred skills
Clinical record review for claim payments, healthcare delivery systems knowledge
Technologies
CPT, HCPCS
Responsibilities
Serve as principal utilization management reviewer for ABA and psychological testing cases; Provide guidance to ABA prior authorization clinical team; Participate in clinical meetings offering subject matter expertise; Contribute to development of medical management programs and policies; Recommend enhancements to managed care review guidelines; Support provider education initiatives on neurodiversity and fraud prevention
Seniority
Senior, hands-on IC