About this role
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.