Job Description

Job Title: Manager, Psychological Services - Part-time (Blair County / Hollidaysburg, PA)
Job ID: 190001EB
Status: Part-Time
Regular/Temporary: Regular
Hours:
Shift: Day Job
Facility: Community Care Behavioral Hlth
Department: Psychological Services
Location: 721 N. Juniata Street, Hollidaysburg PA 16648

Description

Community Care Behavioral Health (CCBH) has an exciting opportunity for a part-time Manager of Psychological Services. Applicants must have a PhD in Psychology or PsyD with an active PA license. Behavioral Health Rehabilitation Services experience is preferred.

 

This is a daylight, part-time role and will require approximately 20 hours per week, covering the Blair Health Choices contract.

 

Community Care Behavioral Health is a nonprofit behavioral health managed care organization, which is part of the University of Pittsburgh Medical Center (UPMC) Insurance Services Division.

 

The Psychologist will assure the quality and efficiency of the health care delivered to Community Care members. This includes responsibility for quality management and specified utilization management. The employee will also participate in care management decisions when appropriate. In addition, the Psychologist is a resource to participating providers in the provision of quality care.

 


Responsibilities:

 

  • Assure that members (in specified levels of care) receive appropriate evaluation, diagnosis, treatment, and screening. Review proposed service denials for specified levels of care and supervises care managers in the utilization of appropriate medical necessity criteria for BHRS/IBHS, and ensures appropriate care management integration and coordination.
  • Clinically review BHRS/IBHS requests for service.
  • Attend BHRS/IBHS interagency meetings when appropriate and necessary for members who are at risk or high risk. Review and assist with the revision of /IBHS procedures.
  • In cooperation with the care manager, write grievance letters. Interface with physician consultants.
  • Attend meetings with physician consultants on a regular basis.
  • Assure the quality of treatment and related services provided by Community Care professional staff, through participation (directly or by designee) in the ongoing quality management and audit processes.
  • Work with the Director of Care Management and Member Services to assure appropriate delivery of care.
  • Work with the Director of Quality Management in designing and evaluating protocols and studies for quality management related to BHRS/IBHS.
  • Participate in provider training and educations concerning BHRS/IBHS and the delivery of BHRS/IBHS services.
  • Monitor BHRS/IBHS services in collaboration with the Care Management Team Coordinator and Director of Care Management. Assure that all clinical staff receives appropriate clinical supervision, staff development, and in-service training related to BHRS/IBHS services.
  • Act as a reviewer, where appropriate, for cases referred by care management staff and authorizing or denying care based upon medical necessity criteria for BHRS or other appropriate levels of care.
  • Work with Community Care staff and others to develop care models and disease management programs related to children's services
  • Advise on needed components on the continuum of care.
  • Is accountable for quality of clinical care provided to Community Care members.
  • Is accountable for effective and appropriate utilization of BHRS and other specified levels of care in the provider network. Is accountable for Family/Member satisfaction with the care management process.
  • Is accountable for provider satisfaction with the care management process.
  • Is accountable for meeting or exceeding NCQA standards and other applicable benchmarks.
  • Is accountable for involvement of network providers in development of care management and disease management programs. Is accountable for prompt response to BHRS packets.
  • Is accountable for developing legitimate BHRS/IBHS impartial review process and procedure. Is accountable for writing impartial reviews.
  • Is accountable for the development and maintenance of effective relationships with providers.

Qualifications

  • PhD in Psychology or PsyD (Pennsylvania Licensure)
  • Unrestricted License in Pennsylvania
  • 6 years clinical experience 
  • 5 years BHRS experience preferred. 
  • Experience in Behavioral Health treatment and program development. 
  • Philosophical compatibility with managed care. 
  • Ability to maintain effective professional liaison with all levels of executive /medical/clinical staff, including professional and institutional providers of care. 
  • Ability to implement programs of quality care analysis, peer review, and professional education.


Licensure, Certifications, and Clearances:

  • Psychologist
  • Act 33 with renewal
  • Act 34 with renewal
  • Act 73 FBI Clearance


  • UPMC is an Equal Opportunity Employer/Disability/Veteran

    Salary Range: $37.40 to $63.36 / hour

    Union Position: non union

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