Clinical Psychologist - BCBA-D
Core
Principal utilization management reviewer for ABA and neuropsychological testing cases, serving as a subject matter expert for Medicaid-wide initiatives and provider education on 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 / Neurodevelopmental disorders
Deliverable
production ML models | product features | dashboards & analysis | research | client delivery | infrastructure | physical/clinical work
Required skills
Utilization management review, ABA treatment expertise, neuropsychological testing review, policy development, fraud/waste/abuse detection, provider education, coding guidelines knowledge
Preferred skills
CPT/HCPCS coding expertise, medical record review for claim payments
Technologies
CPT, HCPCS
Responsibilities
Serve as principal utilization management reviewer for ABA and psychological testing cases; Provide guidance to ABA prior authorization clinical teams; Participate in clinical meetings offering subject matter expertise; Contribute to medical management programs and policies; Recommend enhancements to review guidelines; Support provider education initiatives on neurodiversity and fraud/waste/abuse
Seniority
Senior, hands-on IC