Psychologist Reviewer

Psychologist Reviewer

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.

The Psychologist Reviewer 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 Psychological Testing and Neuropsychological Testing.

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.
• Conduct pre-certification or prior authorization of psychological testing and neuropsychological testing services.
• Partners with Behavioral Health 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.

Position requirements:

• 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.

Preferred qualifications, skills, and experiences:

• Minimum of 2 years experience in a Behavioral Health/Clinical setting preferred.
• Experience with psychological testing and/or neuropsychological testing 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 a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The salary offered for this specific position is based on a number of legitimate, non-discriminatory factors set by the Company. The Company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws.

* 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 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, consistent with the law.