Psychologist Reviewer

Elevance Health • Nashville, TN

17h • Hybrid

About The Position

The Psychologist Reviewer is a member of the LTSS leadership team and oversees behavior support services for people receiving LTSS and comparable populations, including older adults, adults with physical disabilities, and people of any age with intellectual or developmental disabilities. The role collaborates with Medical Directors on Behavior Crisis Prevention and Intervention and Stabilization Services, and oversees quality improvement initiatives related to behavior supports and appropriate psychotropic medication use.

This hybrid position is based in Nashville, Tennessee. Associates are expected to work in an office 1–2 days per week. Candidates must live within reasonable commuting distance of a posting location unless an accommodation is granted as required by law. The role is classified as non-management, exempt, and first shift.

Requirements

• Ph.D. or Psy.D. in clinical or counseling psychology, and managed care experience that includes administering and interpreting psychological test batteries; or 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.
• Tennessee psychologist licensure and experience in Applied Behavior Analysis, or current Board Certified Behavior Analyst certification from the Behavior Analyst Certification Board.
• At least 5 years of experience directing behavior support services, including at least 2 years serving individuals with intellectual or developmental disabilities.
• Experience partnering with Integrated Support Coordination Teams.

Responsibilities

• Partner with health plan LTSS and Behavioral Health leadership to develop and monitor the behavioral health support plan for identified populations.
• 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 review, 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 for psychological and neuropsychological testing.
• Collaborate with Medical Directors to manage Behavior Crisis Prevention and Intervention and Stabilization Services.
• Oversee quality improvement initiatives regarding behavior supports and appropriate psychotropic medication use for the specified populations.

Benefits

• Merit increases
• Paid holidays
• Paid Time Off
• Incentive bonus programs, unless covered by a collective bargaining agreement
• Medical benefits
• Dental insurance
• Vision insurance
• Short- and long-term disability benefits
• 401(k) with match
• Stock purchase plan
• Life insurance
• Wellness programs
• Financial education resources

What This Job Offers

• Job Type: Full-time
• Education Level: Ph.D. or professional degree