Psychologist Reviewer - ABA

Experteer Overview In this role you will assess and guide the level of care for outpatient behavioral health services using Medical Necessity Criteria. You will collaborate with internal utilization review teams and external providers to ensure appropriate, guideline-conform care and efficient use of benefits. You will mentor staff, help develop testing programs, and handle pre-certification, concurrent reviews, and appeals for Behavioral Health OP services. This position sits at the intersection of clinical psychology and managed care, offering impact across therapy, testing, and ABA/ASD services in a hybrid work environment. You will work within Elevance Health’s mission to improve lives and communities by: Compensation / Benefits • Collaborate with utilization review staff and Behavioral Health Providers to ensure appropriate plan utilization and adherence to guidelines • Conduct pre-certification, concurrent review, and appeals for Behavioral Health outpatient services • Mentor Behavioral Health Care Management staff and support interdepartmental initiatives • Assist in developing a program around psychological and neuropsychological testing • Determine appropriateness of level of care based on Medical Necessity Criteria • Coordinate with Medical Directors to align clinical guidelines with license scope Tasks • Ph.D. or Psy.D in clinical/counseling psychology • active unrestricted license as Clinical/Counseling Psychologist • managed care experience with administration/interpretation of psychological test batteries Key requirements • comprehensive benefits package • incentive and recognition programs • equity stock purchase • 401(k) contribution • medical, dental, vision • Paid Time Off