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Elevance Health · 9 hours ago

Psychologist Reviewer - Georgia

Atlanta, GA

Full-time

Hybrid

Entry, Mid Level

2+ years exp

Elevance Health is a health company dedicated to improving lives and communities. The Psychologist Reviewer – Georgia is responsible for collaborating with providers and Medical Directors to determine the appropriateness of level of care based on Medical Necessity Criteria.

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.DManaged care experiencePsychological testingBehavioral Health experienceABA experience

Required

Requires Ph.D. or Psy.D in clinical/counseling psychology and managed care experience which includes experience with the administration and interpretation of psychological test batteries; or any combination of education and experience, which would provide an equivalent background

Most possess an active unrestricted license to practice as Clinical/Counseling Psychologist in North Georgia