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Elevance Health · 3 days ago

Psychologist Reviewer - Georgia

GA-ATLANTA, 740 W PEACHTREE ST NW

Full-time

Hybrid

Entry, Mid Level

2+ years exp

Elevance Health is a health company dedicated to improving lives and communities. They are seeking a Psychologist Reviewer to collaborate with providers and Medical Directors to determine the appropriateness of levels of care based on Medical Necessity Criteria, while conducting reviews and mentoring staff.

Health CareHealth InsurancePersonal HealthWellness

Responsibilities

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

Qualification

Licensed PsychologistPh.D.Psy.D.Managed Care ExperiencePsychological TestingBehavioral Health ExperienceMentoring SkillsCollaboration SkillsCommunication Skills