- This is a remote position.
- Authorize, direct and monitor care for mental health and substance abuse problems according to clinical information given by providers and internal criteria for medical necessity and appropriateness of care.
- Conduct peer reviews with Psychologist and licensed Therapist for outpatient and 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 level clinician.
- Facilitate outpatient rounds offering clinical input and oversight related to outpatient services.
Doctorate degree in Clinical Psychology, Counseling or related field. 5+ years of psychiatric and/or substance abuse experience (including utilization review), preferably in a health care setting. Working knowledge of psychological tests and testing procedures, diagnostic evaluations and evidence based practices.
Unrestricted license as a Psychologist (PhD or PsyD); BCBA certification required for Behavioral Health roles.