Clinical Psychologist - Remote

Overview

The Clinical Psychologist position at CVS Health focuses on the assessment and treatment of neurodevelopmental disorders, particularly in the context of fraud investigation and healthcare management.

In Short

• Review and prepare cases for medical necessity review of ABA.
• Provide input into medical management programs for neurodevelopmental disorders.
• Make recommendations for enhancements to managed care guidelines.
• Support SIU investigators in healthcare fraud cases.
• Research and prepare cases for clinical and legal review.
• Provide day-to-day support for ABA prior authorization clinical teams.
• Attend clinical meetings with care management teams.
• Support provider education initiatives related to neurodiverse specialties.
• Utilize resources to develop evidence supporting fraud allegations.
• Collaborate on enterprise-wide initiatives for neurodevelopmental disorders.

Requirements

• Active and unencumbered psychology licensure.
• Minimum of five years post-graduate clinical experience.
• Direct experience in the Autism space (e.g., ABA, NDBI).
• BCBA or BCBA-D credential preferred.
• Knowledge of CPT and HCPCS coding guidelines.
• Experience in reviewing medical records for claim determinations.
• PhD or PsyD in psychology with specialization in neurodevelopment.

Benefits

• Competitive wages and comprehensive benefits.
• 401(k) plan with company matching contributions.
• No-cost wellness programs for all colleagues.
• Flexible work schedules and paid time off.
• Tuition assistance and dependent care resources.
• Confidential counseling and financial coaching services.