Anthem Licensed Clinical Psychologist Reviewer - Virginia -Richmond or Remote PS14830 in Woodbridge, Virginia

Licensed Clinical Psychologist Reviewer - Virginia -Richmond or Remote PS14830


Location: Richmond, Virginia, United States

Field: Medical

Requisition #: PS14830

Post Date: 5 days ago

This is an exceptional opportunity to do innovative work that means more to you and those we serve at one of America's leading health benefits companies and a Fortune Top 50 Company.

This preferred location for this role is our Richmond, VA office. Following training and evidence of ability to work independently, you will be able to work remote 3 days/week. You must have a high speed internet connection.

Other locations in Virginia will be considered. Work in these locations will be remote. You must have a high speed internet connection.

The Psychologist Reviewer 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, 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 secondary reviews and appeals of community mental health 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.

Requires a Ph.D. or Psy.D in clinical/counseling psychology; managed care experience, including experience with the administration and interpretation of psychological test batteries; or any combination of education and experience, which would provide an equivalent background.

-Must live in Virginia and possess an active, unrestricted license in the state of Virginia to practice as a Clinical/Counseling Psychologist.

-Experience in a Behavioral Health/Clinical setting preferred.

-Experience working with community resources preferred.

-Knowledge of the Medicaid appeals process a plus.

Anthem, Inc. is ranked as one of America’s Most Admired Companies among health insurers by Fortune magazine and is a 2018 DiversityInc magazine Top 50 Company for Diversity. To learn more about our company and apply, please visit us at An Equal Opportunity Employer/Disability/Veteran.