Psychologist Reviewer
- Tampa, FL
- $48.00-55.00 per hour
- Contract
- Full-time
- 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 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.
J2W:CB3