Psychologist Advisor

Key Responsibilities

• Review community-based and children and family services in alignment with best-practice standards, including NCQA standards, and state regulatory requirements.
• Review cases across multiple sites and levels of care to determine medical necessity.
• Conduct peer reviews involving disputed levels of care.
• Consult on quality of care, clinical decisions, case formulations, safety concerns, and appropriate levels of care.
• Collaborate with providers and system stakeholders on member placement, response to treatment, care coordination, quality concerns, and related challenges.
• Participate in quality reviews involving member complaints, grievances, and Government reviews.
• Represent the medical affairs and clinical functions in clinical and administrative meetings, as required.
• Participate in training and education for care managers, providers, and other internal and external stakeholders.
• Communicate with providers regarding clinical and administrative matters.
• Support a multidisciplinary approach through consultation with clinical, medical affairs, network development, performance evaluation, and program integrity functions.
• Serve as a subject-matter expert for internal and external initiatives.
• Perform other duties as assigned.

Skills, Knowledge & Expertise

• Demonstrated experience working with individuals with autism.
• Experience supporting BCBA-related services or programs.
• Must be a resident of Philadelphia.
• Experience providing peer-to-peer support.
• Experience managing or supporting individualized care plans.
• Expertise in psychological assessment, diagnosis, and treatment.
• Strong knowledge of childhood and adolescent mental health disorders.
• Autism Experience: Demonstrated professional experience supporting individuals with autism spectrum disorder and familiarity with their behavioral health and clinical care needs.
  BCBA Experience/Support: Experience working with or supporting Board Certified Behavior Analysts (BCBAs) and collaborating on behaviorally focused care strategies.
• Knowledge of evidence-based practices and research involving children and adolescents.
• Ability to conduct clinical case reviews and assess medical necessity across multiple levels of care.
• Ability to provide effective consultation to clinical staff, providers, and other stakeholders.
• Strong interdisciplinary collaboration and problem-solving skills.
• Excellent written and verbal communication skills.