Psychologist Reviewer

Psychologist Reviewer

Requirements

• Hold an active Oklahoma Psychologist license
• Are familiar with Medicaid guidelines, prior authorization, and telehealth practices
• Thrive in a collaborative, remote work environment

Responsibilities

• Authorize, direct and monitor care for behavioral health and substance abuse problems according to clinical information given by providers and internal criteria for medical necessity and appropriateness of care
• Conduct peer reviews with psychologist and licensed therapist/certified Behavior Analyst for outpatient and/or psychological testing requests
• Interact with network practitioners to provide education on best practice models and utilization management processes
• Interact with the Medical Director, or designee, to discuss clinical authorization questions and concerns regarding specific cases
• Respond to state, provider, and member complaints related to psychological testing or other services requiring review by a PhD/PsyD
• Facilitate outpatient rounds offering clinical input and oversight related to outpatient services
• Performs other duties as assigned
• Complies with all policies and standards

Preferred Qualifications

• PhD Clinical Psychology, Counseling, Behavior Analysis, or related field required
• 2+ years Behavioral Health required
• Working Knowledge of psychological tests and testing procedures, diagnostic evaluations and evidence based practices required
• PSY – Psychologist Unrestricted License (PhD or PsyD) Upon Hire required or: Board Certified Behavior Analyst (BCBA) BCBA-D Upon Hire required