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Psychologist Reviewer - ABA

Elevancehealth

Elevancehealth

Health Insurance

Norfolk, VA - USA

Manager / Team Leader

Hybrid

Experteer Overview

In this virtual role, you partner with internal and external BH teams to judge the appropriateness of care using Medical Necessity Criteria, primarily for ABA services. You will support utilization management, perform pre-certification and appeals, and mentor staff while helping develop psychological and neuropsychological testing programs. Your work enhances care quality and aligns behavioral health services with clinical guidelines. This position offers flexible, hybrid-friendly arrangements and meaningful impact on member outcomes.

Compensation / Benefits

  • comprehensive benefits package
  • incentive and recognition programs
  • equity stock purchase
  • 401(k) contribution
  • medical, dental, vision benefits
  • paid holidays and PTO

Responsibilities

  • Collaborate with UR staff and Behavioral Health Providers to ensure proper plan utilization and adherence to guidelines
  • Conduct pre-certification, concurrent review, and appeals for outpatient BH services
  • Mentor BH Care Management staff and participate in utilization management rounds
  • Support development of programs around psychological and neuropsychological testing
  • Partner on interdepartmental initiatives to improve care pathways
  • Coordinate with ABA clinicians to align services with licensure and guidelines

Key requirements

  • Ph.D. or Psy.D in clinical/counseling psychology with managed care experience
  • Active unrestricted license to practice as Clinical/Counseling Psychologist
  • Experience with administration and interpretation of psychological test batteries
Collaborative mindsetStrong communicationMentorship and trainingPsychological testing and evaluation (administration/interpretation)Neuropsychological testingUtilization management and pre-certification processes

Description

In this virtual role, you partner with internal and external BH teams to judge the appropriateness of care using Medical Necessity Criteria,…
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