Licensed Clinical Psychologist

Job Summary

A company is looking for a Clinical Psychologist to focus on utilization, quality, and review of fraud, waste, and abuse for individual member cases.

Key Responsibilities

• Review and prepare cases for medical necessity review of ABA
• Provide input into medical management programs and make recommendations for enhancements based on healthcare delivery knowledge
• Serve as a clinical SME supporting investigations of suspected healthcare fraud cases and provide guidance to the ABA prior authorization clinical team

Required Qualifications

• Active, current, and unencumbered licensure in the field of psychology
• Minimum of five (5) years post-graduate experience in clinical practice with neurodevelopmental disorders
• Direct experience providing treatment in the Autism space (e.g., ABA, NDBI, EIBI)
• PhD or PsyD, with specialization in neurodevelopment and child and adolescent psychology