Psychologist Reviewer - ABA
About The Position
The Psychologist Reviewer – ABA collaborates with providers, Board Certified Behavior Analysts (BCBAs), and Medical Directors to determine the appropriate level of care based on Medical Necessity Criteria. Outpatient services primarily include Applied Behavior Analysis (ABA), but may also include psychological testing, neuropsychological testing, and mental health support services. This role partners with internal utilization review staff and external behavioral health providers to support appropriate and consistent use of plan benefits, out-of-network services, and clinical guidelines within the scope of the license. The reviewer conducts pre-certification, concurrent reviews, and appeals for outpatient behavioral health services. The role also mentors Behavioral Health Care Management staff through training, participation in utilization management rounds, and interdepartmental initiatives, and assists with developing a program for psychological and neuropsychological testing. The position is described as virtual full-time, with required in-person training sessions. Candidates generally must live within a reasonable commuting distance of a posting location unless an accommodation is granted as required by law. The listed salary range is $93,120 to $167,616 for candidates working in person or virtually in Colorado, Virginia, Massachusetts, Maryland, or California.
Requirements
- Ph.D. or Psy.D. in clinical or counseling psychology, and managed care experience that includes administering and interpreting psychological test batteries; alternatively, an equivalent combination of education and experience.
- Active, unrestricted license to practice as a Clinical/Counseling Psychologist.
Nice To Haves
- At least 2 years of experience in a behavioral health or clinical setting.
- BCBA-D certification (strongly preferred).
- Previous experience working alongside an ABA clinician or in collaboration or partnership with ABA services.
Responsibilities
- Collaborate with providers, BCBAs, and Medical Directors to determine appropriate levels of care using Medical Necessity Criteria.
- Partner with internal utilization review staff and external behavioral health providers to support appropriate and consistent use of plan benefits, out-of-network services, and clinical guidelines within the scope of the license.
- Conduct pre-certification, concurrent reviews, and appeals of outpatient behavioral health services.
- Mentor Behavioral Health Care Management staff by assisting with training, attending utilization management rounds, and serving on interdepartmental initiatives.
- Assist in developing a program around psychological and neuropsychological testing.
Benefits
- Comprehensive benefits package, subject to eligibility requirements.
- Incentive and recognition programs.
- Equity stock purchase plan.
- 401(k) contribution.
- Merit increases.
- Paid holidays.
- Paid Time Off.
- Incentive bonus programs, unless covered by a collective bargaining agreement.
- Medical, dental, and vision benefits.
- Short- and long-term disability benefits.
- 401(k) matching.
- Life insurance.
- Wellness programs.
- Financial education resources.
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What This Job Offers
Job Type
Full-time
Education Level
Ph.D. or professional degree
