Psychologist Reviewer - ABA

Psychologist Reviewer – ABA

Work location:

Hybrid 1 – Associates are required to be in-office 1–2 days per week; alternating remote work is allowed if within commuting distance.

Work hours:

Standard Business Hours, 8am–5pm Monday–Friday.

This role collaborates with providers and Medical Directors to determine appropriateness of care levels 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.

• Partner 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.
• Conduct pre-certification, concurrent review, and appeals of Behavioral Health outpatient services.
• Mentor Behavioral Health Care Management staff by assisting in training, attending utilization management rounds, and serving on interdepartmental initiatives; assist in developing a program around psychological and neuropsychological testing.

• Ph.D. or Psy.
  
  D. in clinical/counseling psychology and managed care experience, including administration and interpretation of psychological test batteries; or equivalent education/experience.
• Active unrestricted license to practice as a Clinical/Counseling Psychologist.

• Minimum of 2 years experience in a behavioral health/clinical setting.
• Experience with Applied Behavioral Analysis and Autism Spectrum Disorder is strongly preferred.

Salary range: $93,120 to $167,616 (depending on location, experience, and other factors).

Locations:
California;
Cleveland, OH;
Columbus, OH;
New York;
New Jersey.

In addition to salary, the company offers a comprehensive benefits package, incentive and recognition programs, equity stock purchase, 401(k) contribution, and other benefits (subject to eligibility requirements).

Elevance Health is an Equal Employment Opportunity employer, and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status, or any other status or condition protected by applicable federal, state, or local laws.

Applicants who require accommodation to participate in the job application process may contact elevancehealthj for assistance. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act. Prospective employees required to be screened under Florida law should review the education and awareness resources at HB531 | Florida Agency for Health Care Administration.