This is a fully remote position, open to applicants in North Carolina.

📋 Description

• Authorize, oversee, and supervise care for behavioral health and/or substance abuse issues based on provider clinical information and internal medical necessity criteria.

• Conduct peer reviews alongside psychologists, behavioral health therapists, and/or Board Certified Behavior Analysts for outpatient services and requests for psychological testing.

• Engage with network practitioners to educate them on best-practice models and utilization management processes.

• Address clinical authorization inquiries and case concerns with the Medical Director or their designee.

• Handle complaints from states, providers, and members related to psychological testing or other services requiring PhD/PsyD review.

• Facilitate outpatient rounds and provide clinical insight and oversight for outpatient services.

• Adhere to all policies and standards.

• Perform additional duties as assigned.

⛳️ Requirements

• A PhD in Clinical Psychology, Counseling, Behavior Analysis, or a related field is required.

• A minimum of 2 years of experience in Behavioral Health is required.

• A working knowledge of psychological tests and testing procedures, diagnostic evaluations, and evidence-based practices is required.

• For ABA Reviewers, a working knowledge of psychological tests, testing procedures, diagnostic evaluations, and evidence-based practices specifically designed for individuals with Autism Spectrum Disorder is required.

• An unrestricted Psychologist License (PhD or PsyD) is required upon hire.

• An active psychologist license in Arkansas, Kentucky, North Carolina, or New Jersey is necessary.

• Licenses from other states may be considered if the candidate is willing and able to obtain the necessary additional licensure.

• BCBA certification is preferred.