TeleSolv is seeking an experienced Psychologist Advisor to provide clinical leadership and oversight of clinical case management. The Psychologist Advisor will consult on quality of care, clinical decision-making, case formulation, safety concerns, case reviews, and appropriate levels of care. The position will also serve as a subject-matter expert for internal and external Government initiatives, drawing on the individual’s education, professional training, licensure, experience, and areas of professional interest.
- 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.
- Demonstrated experience working with individuals with autism.
- 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.
- Education: Doctorate in Psychology
- License/Certification: Licensed Psychologist Advisor in the Commonwealth of Pennsylvania
- Relevant Work Experience: Minimum of 5 years of experience as a Psychologist treating children, adolescents and families providing services in the home, community and/or school; experience conducting biopsychological evaluations, making mental health diagnoses and working collaboratively with professionals across disciplines. A minimum of 5 years of experience providing consultation, supervision, and program administration.
