Psychologist Care Manager

Job Description

Job Summary:

• Authorizes and reviews utilization of psychological and neuropsychological testing services.
• Collects and analyzes utilization data.
• Provides member assistance with mental health and substance abuse issues and participates in special quality improvement projects in collaboration with the other members of the clinical team.

Duties and Responsibilities:

• Reviews psychological and neuropsychological testing requests to ensure medical necessity and effectiveness.
• Provides telephone triage, crisis intervention and emergency authorizations.
• Provides information to members and providers regarding mental health and substance abuse benefits, community treatment resources, mental health managed care programs, and Client Services policies and procedures, and criteria.
• Interacts with the company Medical Directors and others to discuss clinical and authorization questions and concerns regarding specific cases.
• Participates in quality improvement activities, including data collection, tracking, and analysis.
• Leads or participates in activities as requested that help improve Care Center performance, excellence and culture.
• Supports team members and participates in team activities to help build a high-performance team.

Education, Experience and Certifications/ License:

• PHD or PSY D in Psychology.
• Doctoral Degree in behavioral health related field.
• Licensure is required for this position, specifically a current license that meets State, Commonwealth or customer-specific requirements.
• Applicant must be independently licensed in their state of residence and must meet Client credentialing requirements for independent professional practice.
• Licensed Psychologist.
• Experience administering, evaluating and doing the analysis for psychological or neuropsychological testing requests.
• Experience writing complete psychological/neuropsychological evaluations and providing feedback to patients regarding the results and recommendations.
• Minimum of 3 years of post degree experience in psychiatric and/or substance abuse health care setting for Care Managers with Ph.D., including utilization review.

Knowledge, Skills and Abilities:

• Strong organizational, time management and communication skills.
• Knowledge of utilization management procedures, mental health and substance abuse community resources and providers.
• Knowledge of and experience in inpatient setting.
• Knowledge of Diagnostic and Statistical Manual of Mental Disorders (Client–V) or most current diagnostic edition.
• Ability to function independently and as a team member.
• Proficient ability with computer systems.
• Ability to analyze specific utilization problems, plan and implement solutions that directly influence quality of care.