Psychologist Reviewer

Immediate need for a talented Psychologist Reviewer. This is a 12+ months contract opportunity with long-term potential and is located in U.S(Remote). Please review the job description below and contact me ASAP if you are interested.

Job ID: 25-81578

Pay Range: $48 - $55/hour.  Employee benefits include, but are not limited to, health insurance (medical, dental, vision), 401(k) plan, and paid sick leave (depending on work location).

Key Responsibilities:

• 8 am – 5 pm in what time zone they reside within (EST, CST, PST) – position may be part time
• Flexible hours are something the team is discussing to ensure there is coverage for as needed weekends and holidays
• There could be an opportunity to be on weekends only, etc.
• Possibility for Saturday and Sunday
• Authorize, direct and monitor care for behavioral health and/or substance abuse problems according to clinical information given by providers and internal criteria for medical necessity and appropriateness of care
• Board Certified Behavior Analyst (BCBA) BCBA-D Upon Hire preferred"     "Conduct peer reviews with psychologists, behavioral health therapists and/or Board-Certified Behavior Analysts for outpatient services and/or psychological testing requests
• Interact with network practitioners to provide education on best practice models and utilization management processes
• Interact with the Medical Director, or designee, to discuss clinical authorization questions and concerns regarding specific cases
• Respond to state, provider, and member complaints related to psychological testing or other services requiring review by a PhD/PsyD
• Facilitate outpatient rounds offering clinical input and oversight related to outpatient services
• Performs other duties as assigned. Complies with all policies and standards.
• Story behind the need: Business Group & Key Projects:
• Conduct peer reviews with psychologists, behavioral health therapists and/or Board-Certified Behavior Analysts for outpatient services and/or psychological testing requests.
• Authorize, direct and monitor care for behavioral health and/or substance abuse problems according to clinical information given by providers and internal criteria for medical necessity and appropriateness of care
• Interact with network practitioners to provide education on best practice models and utilization management processes.
• Interact with the Medical Director, or designee, to discuss clinical authorization questions and concerns regarding specific cases.
• Respond to state, provider, and member complaints related to psychological testing or other services requiring review by a PhD/PsyD.
• Facilitate outpatient rounds offering clinical input and oversight related to outpatient services.
• 8 am – 5 pm in what time zone they reside within (EST, CST, PST) – Part Time (schedule TBD)
• Weekend & Holiday coverage would be expected.
• The team is very interactive via TEAMs and ensuring questions are answered and support is given.
• There will be a mentor that the new hire will be paired with for learning.
• Compelling Story & Candidate Value Proposition:
• Diverse Case Exposure: Gain experience across a wide range of UM scenarios.
• Growth Potential: Opportunity for full-time conversion.
• Mission-Driven Work: Direct impact on care quality and cost-effectiveness.
• National Reach: Flexibility to work from anywhere in the U.S.

Key Requirements and Technology Experience:  

• Key skills; Licensed Psychologist
• 2+ years Behavioral Health required.
• Working knowledge of psychological tests and testing procedures, diagnostic evaluations and evidence-based practices. 
• Education/Certification Required:PhD Clinical Psychology, Counseling, Behavior Analysis, or related field required.
• License Required: PSY - Psychologist Unrestricted License (PhD or PsyD) Upon Hire required.
• Preferred: Board Certified Behavior Analyst (BCBA) BCBA-D Upon Hire preferred.
• For ABA Reviewers only, working knowledge of psychological tests and testing procedures, diagnostic evaluations and evidence-based practices designed for individuals with autism spectrum disorder.
• Nice to haves: UM Experience.
• 2+ years Behavioral Health required.
• Working knowledge of psychological tests and testing procedures, diagnostic evaluations and evidence-based practices. 

Our client is a leading Healthcare Industry, and we are currently interviewing to fill this and other similar contract positions. If you are interested in this position, please apply online for immediate consideration.

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