Psychologist Reviewer

Position Title : Psychologist Reviewer

Work Location : Remote - Louisana

Assignment Duration : 6-month contract with potential for extension or FTE conversion based on performance.

Work Schedule : 8 am - 5 pm in what time zone they reside within (EST, CST, PST) - position may be part time

Flexible hours are something the team is discussing to ensure there is coverage for as needed weekends and holidays

There could be an opportunity to be on weekends only, etc.

Work Arrangement : Remote - Nationally Sourced

Position Summary :

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

Background & Context :

Conduct peer reviews with psychologists, behavioral health therapists and / or Board Certified Behavior Analysts for outpatient services and / or psychological testing requests

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

Interact with network practitioners to provide education on best practice models and utilization management processes

Interact with the Medical Director, or designee, to discuss clinical authorization questions and concerns regarding specific cases

Respond to state, provider, and member complaints related to psychological testing or other services requiring review by a PhD / PsyD

Facilitate outpatient rounds offering clinical input and oversight related to outpatient services

Key Responsibilities :

Conduct peer reviews with psychologists, behavioral health therapists and / or Board Certified Behavior Analysts for outpatient services and / or psychological testing requests

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

Interact with network practitioners to provide education on best practice models and utilization management processes

Interact with the Medical Director, or designee, to discuss clinical authorization questions and concerns regarding specific cases

Respond to state, provider, and member complaints related to psychological testing or other services requiring review by a PhD / PsyD

Facilitate outpatient rounds offering clinical input and oversight related to outpatient services

Performs other duties as assigned.

Complies with all policies and standards.

Qualification & Experience :

Education / Certification (Required) : PhD Clinical Psychology, Counseling, Behavior Analysis, or related field required

Experience (Required) : 2+ years Behavioral Health required

Knowledge (Required) : Working knowledge of psychological tests and testing procedures, diagnostic evaluations and evidence-based practices. required

ABA-specific (Required for ABA Reviewers only) : working knowledge of psychological tests and testing procedures, diagnostic evaluations and evidence-based practices designed for individuals with Autism Spectrum Disorder. required

Licenses / Certifications (Required) : PSY - Psychologist Unrestricted License (PhD or PsyD) Upon Hire required

Licenses / Certifications (Preferred) : Board Certified Behavior Analyst (BCBA) BCBA-D Upon Hire preferred