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This is a remote position in PA, candidates must be licensed and reside in PA with the ability to travel to local offices in Newtown or Bethlehem as needed.
This position supports the clinical vision for the health plan(s) and makes independent medical necessity and appropriateness determination, as well as Benefit (UM) decisions and provides independent psychological consultation to Magellan’s medical and care management staff.
• Participates in team discussions with other clinicians and grand rounds to support the development of Magellan’s clinical program(s).
• Provides Magellan team with information on the treatment of behavioral health, chronic pain, substance abuse such as opioid addiction, opioid dependence, and clinical variations, areas of opportunities, gaps in care pain point/barriers to delivering quality care or support to patients and treating physicians.
• Contributes to and reviews program materials to ensure appropriate clinical direction, providing Magellan team with key evidence-based medicine, care guidelines, research studies, professional organizations, and guidelines/standards as applicable and needed.
• Evaluates requests for specialist psychological assessment and treatment of a wide range of mental health problems of varying severity and complexity.
• Reviews authorization requests, makes medical necessity determination and Benefit (UM) decisions for Partial Hospital Program (PHP) and Intensive Outpatient Program (IOP) utilizing medical necessity criteria to ensure appropriate levels of care is being recommended for our members.
• Reviews authorization requests for children’s community-based services: Behavioral Health Rehabilitative Services and Applied Behavioral Analysis (ABA) utilizing medical necessity criteria to ensure appropriate levels of care are being recommended for our members.
• Evaluates and assesses psychological therapies, risk assessment, training and supervision.
• Assesses psychological interventions.
• Maintains current awareness of developments in relevant fields.
• Provides guidance on the use of assessment tools such as those used in chronic pain program (such as the West Haven-Yale Multidimensional Pain Inventory, WHYMPI) to ensure appropriate use and interpretation of scores.
• Reviews clinical cases with clinical management teams; and such other similar services as may be requested from time to time.
• Maintains familiarity on current Neuropsychological Testing and Psychological Testing Indications, Clinical factors, requirements and guidelines.
• Consults and reviews psychological and neuropsychological testing processes and interpretation of results.
• Other duties as assigned.
Other Job Requirements
Responsibilities
Licensure is required for this position, specifically a current license that meets State, Commonwealth or customer-specific requirements.
Minimum 7 years experience post degree in healthcare, behavioral health, psychiatric and/or substance abuse health care setting.
Strong organization, time management and communication skills.
Knowledge of utilization management procedures, ABA, mental health and substance abuse community resources and providers.
Knowledge and experience in inpatient and/or outpatient setting.
Knowledge of DSM V or most current diagnostic edition.
Ability to analyze specific utilization problems, plan and implement solutions that directly influence quality of care.
General Job Information
Title
Psychologist Advisor – PA
Grade
29
Work Experience – Required
Behavioral Health
Work Experience – Preferred
Education – Required
PhD – Clinical Psychology, PsyD – Psychology
Education – Preferred
License and Certifications – Required
PSY – Psychologist – Care Mgmt
License and Certifications – Preferred
BCBA – Board Certified Behavior Analyst – Care Mgmt
Salary Range
Salary Minimum:
$93,955
Salary Maximum:
$159,725
This information reflects the anticipated base salary range for this position based on current national data. Minimums and maximums may vary based on location. Actual pay will be adjusted based on an individual’s skills, experience, education, and other job-related factors permitted by law.
This position may be eligible for short-term incentives as well as a comprehensive benefits package. Magellan offers a broad range of health, life, voluntary and other benefits and perks that enhance your physical, mental, emotional and financial wellbeing.
Magellan Health, Inc. is proud to be an Equal Opportunity Employer and a Tobacco-free workplace. EOE/M/F/Vet/Disabled.
Every employee must understand, comply with and attest to the security responsibilities and security controls unique to their position; and comply with all applicable legal, regulatory, and contractual requirements and internal policies and procedures.
