Clinical Psychologist

Job description

Job Summary: The Clinical Psychologist provides Behavioral Health coverage determination for utilization management to ensure members receive appropriate and medically necessary care in the most cost-effective setting. Essential Functions: - Assume responsibility for the overall safety of patients with a BH diagnosis - Serve as the clinical lead in developing and implementing evidenced based clinical policies and practices - Participate in regulatory/accreditation reviews - Assume key role in quality improvement initiatives, case management activities and member safety activities (i.e. incident management) - Oversight and quality improvement activities associated with case management activities - Provide guidance to BH orientation and network development/ recruitment in conjunction with provider relations, value-based contracting, support of episodes of care and full integration of BH services - Assist in the review of utilization data to identify variances in patterns, and provide feedback and education to MCP staff and providers as appropriate - Represent CareSource as the primary clinical liaison to members, providers and State agencies - Support of regulatory and accreditation...