Licensed Psychologist Peer Reviewer - ABA Autism - Remote

Optum; Houston (TX); Remote; USD 89,000 - 161,000; Full time

Job summary

A global healthcare organization is seeking a Licensed Psychologist Peer Reviewer specializing in ABA treatment for autism. Responsibilities include reviewing service requests, participating in consultations, and ensuring compliance with guidelines. This remote role requires a current unrestricted license and clinical experience with Autism Spectrum Disorder. Competitive salary ranging from $89,900 to $160,600 annually along with comprehensive benefits.

Benefits

Comprehensive benefits package

Incentive and recognition programs

Equity stock purchase

401k contribution

Qualifications

• Current unrestricted license allowing full independent practice.
• Experience working with managed care entities.
• Secure home office setup and access to broadband.

Responsibilities

• Review ABA service requests for Commercial and Medicaid Plans.
• Participate in peer consultations and staff meetings.
• Conduct clinical reviews for ABA and Assessment services.

Skills

Clinical experience with Autism Spectrum Disorder

Organizational and time-management skills

Written and verbal communication skills

Ability to thrive in a fast-paced environment

Proficient computer skills

Ability to work collaboratively

Education

Licensed doctoral level Psychologist (Ph.D. or Psy.D.)

Tools

Windows OS

Microsoft Office (Outlook, Word, Excel)

Job description

Licensed Psychologist Peer Reviewer - ABA Autism - Remote

Licensed Psychologist Peer Reviewer - ABA Autism - Remote

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Description

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together.

The role of the Psychologist Peer Reviewer for Applied Behavior Analysis - Autism Services involves applying clinical and benefit plan criteria to service requests for initial and continued coverage of ABA treatment, shaping and modifying treatment as appropriate, and issuing an adverse benefit determination if treatment is not medically necessary.

Primary Responsibilities:

• ABA service requests for both Commercial and Medicaid Plans
• Participate in peer consultations, staff meetings, and trainings; be responsible for composing and entering clinical determinations that comply with all federal, state, and local guideline requirements; and perform other duties as required.
• The Psychologist Reviewer may conduct clinical reviews of the following type during a typical workday:
• • Clinical review of requests for ABA and Assessment services
  • Requests for Single Case Agreements
  • Appeals of previously denied services

Required Qualifications:

• Licensed doctoral level Psychologist (Ph.D. or Psy.D.) Your license must be current, allow for full independent practice, and be unrestricted. You may be asked to obtain additional state licenses to meet growing business needs
• Clinical experience with Autism Spectrum Disorder
• Experience working with managed care entities
• Proven solid organizational and time-management skills, with the ability to prioritize multiple demands within strict turn-around-time requirements and track multiple state and business nuances for the cases you review
• Proven solid written and verbal communication and negotiation skills
• Ability to work well independently and collaborate with others on a clinical team
• Ability to thrive in a fast-paced environment
• Proven solid computer skills, including facility with Windows OS, Outlook, Word, and Excel
• Ability to type proficiently, and for a significant portion of your day comfortably, while speaking on the phone
• Secure, private area of your home to set up an office, and access to a broadband ISP
• Ability to work full-time during normal business hours Monday through Friday

Preferred Qualifications:

• BCBA, BCBA-D, LBA (in addition to being a licensed psychologist)
• 3+ years of post-licensure experience
• 2+ years of experience testing children with Autism
• APA accredited training and internship
• Applied Behavior Analysis training and/or experience
• Experience working in a managed care setting
• Peer review experience with managed care
• Clinical experience with children and adolescents
• Behavior Modification expertise
• Advanced computer skills using Excel and Access Databases

Compensation and Benefits:

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution. The salary for this role will range from $89,900 to $160,600 annually based on full-time employment. We comply with all minimum wage laws as applicable.

EEO and Workplace Information:

UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.

UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.