Sr Psychologist-I/DD (Full-time Remote, North Carolina Based)

Join Alliance Health as a Sr Psychologist I/DD – Remote, North Carolina in North Carolina. The Sr Psychologist – I/DD is a licensed professional who brings both clinical and health plan experience in intellectual and developmental disability (I/DD) to the Alliance Medical Management team, primarily performing utilization management (UM) activities (e. g.

Key Responsibilities

• Clinical Oversight & Medical Review.

• Provide Peer Review (second level review) to determine the medical necessity of authorization for services requested under NC Medicaid and relevant.

• Waivers, particularly those utilized by Alliance members with I/DD.

• Conduct initial, concurrent, and retrospective reviews using NC Medicaid.

Requirements

• Provide clinical guidance and leadership to promote collaboration between physical health, behavioral health, and care management teams

• Assist with development of clinical guidelines, approval criteria, and UM decision support tools

• Participate in appeal-related mediation activities and Office of Administrative Hearing (OAH) processes as required, providing clinical expertise and documentation support

• Participate in court hearings to provide expert testimony during court proceedings to suggest or validate treatment recommendations Analyze data and make recommendations for Quality Improvement

Benefits & Compensation

• Salary: $102K - $130K

Work Schedule

• Full-Time position.

• Remote position - work from anywhere.

• Flexible scheduling available.

This position offers remote work flexibility. Work with Alliance Health in North Carolina.