Psychologist Reviewer - ABA

Job Overview Work location – Hybrid 1 – This role requires associates to be in-office 1-2 days per week, fostering collaboration and connectivity while providing flexibility to support productivity and work-life balance. Alternate locations may be considered if candidates reside within a commuting distance of an office. Work hours: Standard Business Hours, 8am-5pm Monday - Friday Position Overview 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 Behavior Analysis, and Autism Spectrum Disorder Services. Responsibilities 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. 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 Minimum of 2 years experience in a Behavioral Health/Clinical setting preferred. Experience with Applied Behavioral Analysis and Autism Spectrum Disorder is strongly preferred. Location and Salary Location(s): California; Cleveland, OH; Columbus, OH; New York; New Jersey Salary range: $93,120 to $167,616 (for candidates working in person or virtually in the above locations). The range may be modified in the future and actual compensation may vary based on geographic location, work experience, education, and/or skill level. Benefits include a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution. Equal Employment Opportunity Statement 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 View email address on click.appcast.io for assistance. #J-18808-Ljbffr