Psychologist Reviewer - Kansas - part time
About The Position
This is a part-time (20 hours/week) virtual role for a licensed Psychologist domiciled in Kansas. The primary responsibility is to collaborate with providers and Medical Directors to determine the appropriateness of the level of care based on Medical Necessity Criteria, mainly for ABA services. The role may also involve reviewing other outpatient levels of care such as Individual Therapy, Group Therapy, Family Therapy, Marriage/Couples Therapy, Psychological Testing, Neuropsychological Testing, Psychosocial Rehabilitation, Intensive Outpatient Treatment, Day Treatment, and Mental Health Support Services. Additionally, the Psychologist Reviewer will act as a subject matter expert, collaborating with plan leadership, providers, and other stakeholders to improve service delivery for Autism Spectrum Disorder.
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.
- Must be licensed and domiciled in the state of Kansas.
Nice To Haves
- Minimum of 2 years experience in a Behavioral Health/Clinical setting preferred.
- Previous experience working alongside an ABA clinician and/or in collaboration with ABA services is strongly preferred.
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.
Benefits
- merit increases
- paid holidays
- Paid Time Off
- incentive bonus programs
- medical
- dental
- vision
- short and long term disability benefits
- 401(k) +match
- stock purchase plan
- life insurance
- wellness programs
- financial education resources
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What This Job Offers
Job Type
Part-time
Career Level
Mid Level
Education Level
Ph.D. or professional degree
