Licensed Psychologist Peer Reviewer

Job Summary

To support a growing team, the part-time Licensed Psychologist Peer Reviewer will apply clinical criteria to review Commercial, Medicaid, and Medicare cases, making determinations on treatment coverage while working remotely from the Tri-state Area.

Key responsibilities:

• Review outpatient treatment plans and requests for psychological testing to ensure compliance with clinical criteria
• Participate in peer consultations and staff meetings, documenting determinations according to regulatory guidelines
• Evaluate appeals for denied services and claims related to outpatient non-MD services

Required qualifications:

• Licensed doctoral level (Ph.D. or Psy.D.) Psychologist with unrestricted practice
• 5+ years of post-licensure experience, including peer reviews and working with children and adolescents
• Experience with insurance agencies and mental health/substance use disorders
• Proficient in computer skills, including Windows OS, Outlook, Word, and Excel
• Permanent residence in New York, New Jersey, or Connecticut