BCBA-D Clinical Psychologist – Neurodevelopment & UM Lead

MePA; Louisiana (MO); Hybrid; USD 90,000 - 195,000; Full time

Job summary

CVS Health, including Aetna Medicaid, is seeking a licensed clinician to serve as a principal utilization management reviewer for neurodevelopmental disorders, including ABA. The role reports to the Executive Behavioral Health Medical Director and focuses on utilization, quality, and abuse reviews for members across Aetna.

The position requires a PhD or PsyD in neurodevelopment and child/adolescent psychology, LA licensure, BCBA-D, and 5+ years of relevant experience.

Qualifications

• Five (5) years of clinical experience in the assessment and treatment of neurodevelopmental disorders, including Autism Spectrum Disorder.
• Direct experience providing treatment within the autism field, such as ABA, NDBI, or EIBI.
• License in Louisiana and willingness to obtain additional licensure as required.
• BCBA-D credential held.

Responsibilities

• Serve as the principal utilization management reviewer for cases related to Applied Behavior Analysis (ABA).
• Provide daily support and guidance to the ABA prior authorization clinical team and health plan medical directors.
• Serve as a principal utilization management reviewer for cases related to psychological and neuropsychological testing.
• Attend and actively participate in clinical meetings with care management and utilization management teams, offering subject matter expertise on all ABA-related questions and member concerns.
• Contribute to the development and refinement of medical management programs and policies addressing neurodevelopmental disorders.
• Recommend enhancements to managed care review guidelines and clinical criteria, drawing on knowledge of health care delivery systems, utilization methodologies, reimbursement models, and treatment protocols.
• Offer subject matter expert support for Medicaid-wide initiatives that benefit members with neurodevelopmental disorders.
• Support provider education initiatives for professionals specializing in neurodiversity, including quality assurance and issues related to fraud, waste, and abuse.

Education

Doctoral degree (PhD or PsyD) with a specialization in neurodevelopment and child and adolescent psychology

Active and unrestricted state license(s) in Louisiana (LA)

Board Certified Behavior Analyst-Doctoral (BCBA-D) credential

Job description

CVS Health, including Aetna Medicaid, is seeking a licensed clinician to serve as a principal utilization management reviewer for neurodevelopmental disorders, including ABA. The role reports to the Executive Behavioral Health Medical Director and focuses on utilization, quality, and abuse reviews for members across Aetna.

The position requires a PhD or PsyD in neurodevelopment and child/adolescent psychology, LA licensure, BCBA-D, and 5+ years of relevant experience.