Anticipated End Date:
2026-08-15

Position Title:
Psychologist Reviewer Senior - ABA

Job Description:

Work location - Virtual

This role enables associates to work virtually full-time, except for required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. 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 accommodation is granted as required by law.

The Psychologist Reviewer Senior - ABA is responsible for providing day-to-day guidance, support, and leadership for clinical and/or quality activities under the guidance of our Director of Behavioral Health Psychology Services. May be responsible for supporting our health plans in ensuring clinical integrity of broad and significant clinical programs. May perform clinical review and participate at complaint hearings.

Primary duties may include, but are not limited to:

• Provide clinical guidance for programs.
• Serves as a resource and consultant for other areas of the company.
• Prepare and provide consumer and provider education, trainings, or presentations as needed.
• May be required to represent the company to external entities and/or serve on internal and/or external committees.
• Responsible for collaborating with providers and Medical Directors to determine appropriateness of level of care based on Medical Necessity Criteria.
• Outpatient levels of care would primarily include Applied Behavior Analysis (ABA). Other levels of care could include Psychological Testing, Neuropsychological Testing, and Mental Health Support Services.
• 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.
• Conducts pre-certification, concurrent review, and appeals of Behavioral Health OP services.
• Mentors Behavioral Health Care 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.

Minimum requirements:

• Requires Ph.D. or Psy.D in clinical/counseling psychology and minimum of 5 years of experience in a Behavioral Health/Clinical setting 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.
• Most possess an active unrestricted license to practice as Clinical/Counseling Psychologist.

Preferred qualifications, skills, and experiences:

• BCBA-D is strongly preferred.
• Previous UM experience is strongly preferred.

For candidates working in person or virtually in the below locations, the salary* range for this specific position is $107,280 to $185,058

Locations: Colorado, Virginia, Massachusetts, Maryland

In addition to your salary, 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). The salary offered for this specific position is based on a number of legitimate, non-discriminatory factors set by the Company. The Company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws.

* The salary range is the range Elevance Health in good faith believes is the range of possible compensation for this role at the time of this posting. This range may be modified in the future and actual compensation may vary from posting based on geographic location, work experience, education, and/or skill level. Even within the range, the actual compensation will vary depending on the above factors as well as market/business considerations. No amount is wages or compensation until such amount is earned, vested, and determinable under the terms and conditions of the applicable policies and plans. The amount and availability of any bonus, commission, benefits, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company's sole discretion, consistent with the law.

Job Level:
Non-Management Exempt

Workshift:
1st Shift (United States of America)

Job Family:
MED > Licensed/Certified Behavioral Health Role

Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.

NOTE: Workday keeps job postings active through 11:59:59 PM on the day before the listed end date. Example: If the end date is 3/13, the posting will automatically come down on 3/12 at 11:59:59 PM. In other words - the job is posted until 3/13, not through 3/13.