Position Purpose:
Authorize, direct and monitor care for behavioral health and/or substance abuse problems according to clinical information given by providers and internal criteria for medical necessity and appropriateness of care
Conduct peer reviews with psychologists, behavioral health therapists and/or Board Certified Behavior Analysts for outpatient services 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.
Education/experience:
PhD Clinical Psychology, Counseling, Behavior Analysis, or related field required
Licenses/Certifications:
PSY – Psychologist Unrestricted License (PhD or PsyD) Upon Hire required
Board Certified Behavior Analyst (BCBA) BCBA-D Upon Hire preferred
Position is offered by a no fee agency.
SPECTRAFORCE is an equal opportunity employer and does not discriminate against any employee or applicant for employment because of race, religion, color, sex, national origin, age, sexual orientation, gender identity, genetic information, disability or veteran status, or any other category protected by applicable federal, state, or local laws. Please contact Human Resources at nahr@spectraforce.com if you require reasonable accommodation.
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