Psychologist Reviewer - ABA

Work location
- Virtual

This role enables associates to work virtually full-time, except for required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development.

Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law.

Work hours:

Standard Business Hours, 8am-5pm Monday
- Friday

The Psychologist Reviewer – ABA is responsible for collaborating with providers and Medical Directors to determine appropriateness of level of care based on Medical Necessity Criteria. Outpatient levels of care include:
Individual Therapy, Group Therapy, Family Therapy, Marriage/Couples Therapy, Psychological Testing, Neuropsychological Testing, Psychosocial Rehabilitation, Intensive Outpatient Treatment, Day Treatment, Mental Health Support Services, Applied Behavioral Analysis, and Autism Spectrum Disorder Services.

Primary duties may include, but are not limited to:

• 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.

• Requires Ph.D. or Psy.
  
  D in clinical/counseling psychology and managed care experience which includes experience with the administration and interpretation of psychological test batteries; or any combination of education and experience, which would provide an equivalent background.

• Must possess an active unrestricted license to practice as Clinical/Counseling Psychologist.

• Minimum of 2 years experience in a Behavioral Health/Clinical setting preferred.

• Experience with Applied Behavioral Analysis and Autism Spectrum Disorder is strongly preferred.

For candidates working in person or virtually in the below locations, the salary
* range for this specific position is $93,120 to $167,616

Location(s):
California;
Cleveland, OH;
Columbus, OH;
New York;
New Jersey

In addition to your salary, Elevance Health offers benefits such as:

• comprehensive benefits package
• incentive and recognition programs
• equity stock purchase
• 401k contribution (all benefits are subject to eligibility requirements)

In addition to your salary, Elevance Health offers benefits such as a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements).

• The salary range is the range Elevance Health in good faith believes is the range of possible compensation for this role at the time of this posting. This range may be modified in the future and actual compensation may vary from posting based on geographic location, work experience, education, and/or skill level. Even within the range, the actual compensation will vary depending on the above factors as well as market/business considerations.
  
  No amount is wages or compensation until such amount is earned, vested, and determinable under the terms and conditions of the applicable policies and plans. The amount and availability of any bonus, commission, benefits, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company’s sole discretion, consistent with the law.

Elevance Health is a health company dedicated to improving lives and communities – and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for…