CVS Health · 2 months ago
Clinical Psychologist - BCBA/BCBA-D
United States
Full-time
Remote
Senior Level
$90K/yr - $216K/yr
5+ years expCVS Health is the nation’s leading health solutions company, dedicated to transforming health care. The Clinical Psychologist will be responsible for utilization management reviews for cases related to Applied Behavior Analysis, providing support to clinical teams, and contributing to the development of medical management programs for neurodevelopmental disorders.
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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
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 comprehensive 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
Qualification
Required
A minimum of five (5) years of clinical experience in the assessment and treatment of neurodevelopmental disorders, including, but not limited to, Autism Spectrum Disorder
Doctoral degree (PhD or PsyD) with a specialization in neurodevelopment and child and adolescent psychology
Direct experience providing treatment within the autism field, such as Applied Behavior Analysis (ABA), Naturalistic Developmental Behavioral Interventions (NDBI), or Early Intensive Behavioral Intervention (EIBI)
Active and unrestricted state license(s), with a minimum of five (5) years of post-graduate direct patient care experience
Board Certified Behavior Analyst (BCBA) or Board Certified Behavior Analyst-Doctoral (BCBA-D) credential
Preferred
Demonstrated knowledge of, and experience with, Current Procedural Terminology (CPT) and Healthcare Common Procedure Coding System (HCPCS) coding guidelines and principles
Experience utilizing clinical expertise to review medical records and determine claim payments in alignment with company, state, federal, and industry standard coding principles and guidelines
Primary state licensure in Virginia (VA), Louisiana (LA), and/or Oklahoma (OK), with the willingness and ability to obtain additional licensure as required
Benefits
Affordable medical plan options
401(k) plan (including matching company contributions)
Employee stock purchase plan
No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching
Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility
Company
CVS Health
CVS Health is a health solutions company that provides an integrated healthcare services to its members.
10001+ employees
Funding
Current Stage
Public CompanyTotal Funding
$4BKey Investors
Michigan Economic Development CorporationStarboard Value
2025-08-15Post Ipo Debt· $4B
2025-07-17Grant· $1.5M
2019-11-25Post Ipo Equity
Leadership Team
David Joyner
President and Chief Executive Officer, CVS Health
Chandra McMahon
SVP & CISO
Recent News
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