Position Description

Psychologist Advisor
Location Dublin, OH
Primary Job Function Behavioral Health
ID** 21952
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Your career starts now. We’re looking for the next generation of health care leaders.

At AmeriHealth Caritas, we’re passionate about helping people get care, stay well and build healthy communities. As one of the nation's leaders in health care solutions, we offer our associates the opportunity to impact the lives of millions of people through our national footprint of products, services and award-winning programs. AmeriHealth Caritas is seeking talented, passionate individuals to join our team. Together we can build healthier communities. If you want to make a difference, we’d like to hear from you.

Headquartered in Philadelphia, AmeriHealth Caritas is a mission-driven organization with more than 30 years of experience. We deliver comprehensive, outcomes-driven care to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services. Discover more about us at www.amerihealthcaritas.com.

Responsibilities:

The Psychologist Advisor (“PA”) is responsible for providing consultation and determinations for clinical cases in need of review.  The PA supports the clinical department in applying Medical Necessity Criteria, Appendix T, to render determinations to complaints & grievances for specific levels of care.  In addition, the PA will assess clinical aspects of quality of care issues pertaining to best practice standards.. The PA will provide quality monitoring related to the CBHNP Children’s Model.

 

The PA will perform quality improvement activities consistent with qualifications as approved by the CBHNP Credentialing Process and verified through an NCQA Credentialing Verification Organization.

Education/Experience:

  • PhD Psychology.
  • Licensed Psychologist.
  • Proficiency with Microsoft Office Suite (Word, Excel, Power Point).  Access is a plus.  Consistent word processing speed and accuracy of 50 or more words per minute. 
  • 5-10 years Clinical Behavioral Health.
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