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Psychologist Reviewer - Kansas

Elevance Health • Olathe, KS 66063 • Posted 23 days ago

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Hybrid • Full-time • Mid Level

Job Highlights

Using AI ⚡ to summarize the original job post

The Psychologist Reviewer in Kansas is responsible for collaborating with providers and Medical Directors to determine the appropriateness of level of care based on Medical Necessity Criteria. This role involves conducting pre-certification, concurrent review, and appeals of Behavioral Health Outpatient services, as well as mentoring Behavioral Health Care Management staff. The successful candidate will be licensed and domiciled in Kansas, within 50 miles of Topeka or Olathe.

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.

Qualifications

Required

  • Ph.D. or Psy.D in clinical/counseling psychology
  • Managed care experience which includes experience with the administration and interpretation of psychological test batteries
  • Active unrestricted license to practice as Clinical/Counseling Psychologist in the state of Kansas

Preferred

  • Minimum of 2 years' experience in a Behavioral Health/Clinical setting

About Elevance Health

Elevance Health operates in the healthcare industry, providing health plans and a wide range of solutions such as clinical, behavioral, pharmacy, and complex-care services to promote whole health. They focus on redefining health, strengthening communities, and driving positive change in the healthcare sector through research, innovation, and collaborations with experts and institutions.

Full Job Description

Please note: The successful hire will be licensed and domiciled in the state of Kansas and will be within 50 miles of our Kansas Pulse Point locations in Topeka or Olathe.

The **Psychologist Reviewer - Kansas** is responsible for collaborating with providers and Medical Directors to determine appropriateness of level of care based on Medical Necessity Criteria. Outpatient levels of care include: Individual Therapy, Group Therapy, Family Therapy, Marriage/Couples Therapy, Psychological Testing, Neuropsychological Testing, ABA, Psychosocial Rehabilitation, Intensive Outpatient Treatment, Day Treatment, and Mental Health Support Services.

Primary duties may include, but are not limited to:

+ 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.

Position Requirements:

+ 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 the state of Kansas.

+ Minimum of 2 years' experience in a Behavioral Health/Clinical setting preferred.

Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.

Who We Are

Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.

How We Work

At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business.

We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.

Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process. Candidates must reside within 50 miles or 1-hour commute each way of a relevant Elevance Health location.

The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws.

Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact elevancehealthjobssupport@elevancehealth.com for assistance.