Remote Psychologist Reviewer ABA Utilization Management

The Elevance Health Companies, Inc.; Indianapolis (IN); On-site; USD 93,120 - 160,632; Full time

Job summary

Elevance Health is seeking a Psychologist Reviewer – ABA to join our behavioral health team in a virtual, full‑time capacity. You will collaborate with providers, BCBAs and Medical Directors to verify medical necessity and appropriate levels of care across ABA and psychological services.

The position requires a Ph.D. or Psy.D. in clinical/counseling psychology, an active license, and experience in managed care. Travel is not required, training sessions are in-person as needed.

Qualifications

• Ph.D. or Psy.D. in clinical/counseling psychology required.
• Managed care experience including administration and interpretation of psychological test batteries.
• Active unrestricted license to practice as a Clinical/Counseling Psychologist preferred.

Responsibilities

• Collaborate with providers, BCBAs and Medical Directors to determine appropriateness of level of care based on Medical Necessity Criteria
• Review outpatient levels of care including Applied Behavior Analysis (ABA), psychological testing, neuropsychological testing, and mental health support services
• Partner 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
• Conduct pre-certification, concurrent review, and appeals of Behavioral Health OP services
• Mentor Behavioral Health Care Management staff by assisting in training, attending utilization management rounds, and serving on interdepartmental initiatives
• Assist in developing a program around psychological and neuropsychological testing

Skills

BCBA-D preferred

Education

Ph.D. or Psy.D. in Clinical/Counseling Psychology

Active unrestricted license to practice as a Clinical/Counseling Psychologist (preferred)

Job description

Elevance Health is seeking a Psychologist Reviewer – ABA to join our behavioral health team in a virtual, full‑time capacity. You will collaborate with providers, BCBAs and Medical Directors to verify medical necessity and appropriate levels of care across ABA and psychological services.

The position requires a Ph.D. or Psy.D. in clinical/counseling psychology, an active license, and experience in managed care. Travel is not required, training sessions are in-person as needed.