Licensed Psychologist – ABA Peer Reviewer (Remote)

MePA; Maryland Heights (MO); Remote; USD 92,000 - 164,000; Full time

Job summary

UnitedHealth Group is seeking a Licensed Psychologist, Peer Reviewer for ABA Services to evaluate requests for ABA treatment and assessment coverage. You will apply clinical criteria and plan requirements, discussing treatment considerations with providers and issuing determinations as needed.

Responsibilities include reviewing ABA requests for federal/state plan compliance, performing peer consultations, and contributing to training activities.

Qualifications

• Licensed doctoral level Psychologist (Ph.D. or Psy.D.) with a current unrestricted license.
• 3+ years of post-licensure experience.
• Clinical experience with Autism Spectrum Disorder.
• Experience working with managed care entities.
• Proficiency in MS Office Suite.
• Ability to type proficiently while speaking on the phone.
• Strong organizational and time-management skills.
• Ability to work independently and collaborate on a clinical team.
• Strong written and verbal communication and negotiation skills.
• Willingness to obtain additional state licenses as needed.
• Advanced computer skills including Excel and Access.

Responsibilities

• Review initial and continued ABA service requests for commercial and Medicaid plans.
• Apply clinical criteria, benefit-plan requirements, and applicable federal/state/local requirements.
• Conduct peer-to-peer consultations with treating providers.
• Prepare and enter clear clinical determinations, including adverse determinations when needed.
• Review requests for single-case agreements and denied-service appeals.
• Participate in peer consultations, meetings, and training activities.
• Perform other duties as assigned.

Skills

Licensed psychologist

Post-licensure experience

Autism Spectrum Disorder

Managed care experience

MS Office

Typing on the phone

Organization & time management

Independent work

Communication skills

Licenses (state requirements)

Additional licenses (as needed)

Full-time availability

Licensure in multiple states (pref.)

Excel

Access Databases

Tools

Excel

Access Databases

Job description

UnitedHealth Group is seeking a Licensed Psychologist, Peer Reviewer for ABA Services to evaluate requests for ABA treatment and assessment coverage. You will apply clinical criteria and plan requirements, discussing treatment considerations with providers and issuing determinations as needed.

Responsibilities include reviewing ABA requests for federal/state plan compliance, performing peer consultations, and contributing to training activities.