Psychologist Reviewer - part time

Elevance Health•Tampa, FL

16d•Hybrid

About The Position

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. This approach combines structured office engagement with the autonomy of virtual work, promoting a dynamic and adaptable workplace. Alternate locations may be considered if candidates reside within a commuting distance from an office. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. Work hours: 20 hours per week; the successful hire will be expected to work 5 days a week, with one day working in-office as per company policy. Afternoon hours would be be preferred but not required. The Psychologist Reviewer - part time 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.

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.

Nice To Haves

Minimum of 2 years experience in a Behavioral Health/Clinical setting preferred.
Experience with psychological testing and/or neuropsychological testing 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.
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.

Benefits

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).
merit increases
paid holidays
Paid Time Off
incentive bonus programs (unless covered by a collective bargaining agreement)
medical, dental, vision, short and long term disability benefits
401(k) +match
stock purchase plan
life insurance
wellness programs
financial education resources