Licensed Psychologist - Peer Reviewer - Remote anywhere USA

UnitedHealth Group; Denver (CO); Remote; USD 89,000 - 105,000; Full time

Job summary

Join a forward-thinking organization dedicated to improving health outcomes through innovative care solutions. As a Psychologist Peer Reviewer, you will play a critical role in assessing treatment coverage and ensuring patients receive the necessary care. This position offers the flexibility to work remotely from anywhere in the U.S., allowing you to balance your professional and personal life effectively. With a commitment to diversity and inclusion, you will be part of a team that values your contributions and supports your career growth. Embrace this opportunity to make a meaningful impact on the communities we serve while advancing health equity on a global scale.

Benefits

Comprehensive Benefits Package

Incentive and Recognition Programs

401(k) Contributions

Equity Stock Purchase

Qualifications

• Licensed doctoral level Psychologist with 3+ years of experience.
• Experience with insurance agencies and psychological testing.

Responsibilities

• Handle psychological testing service requests and outpatient treatments.
• Conduct non-MD clinical reviews and manage peer consultations.

Skills

Psychological Testing

Clinical Review

Insurance Agency Experience

Proficient Typing

Windows OS

Outlook

Word

Excel

Education

Ph.D. or Psy.D. in Psychology

Tools

Windows OS

Microsoft Outlook

Microsoft Word

Microsoft Excel

Job 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 diversity and inclusion, talented peers, comprehensive benefits, and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together.

Role Overview

The role of the Psychologist Peer Reviewer involves applying clinical criteria and benefit plan requirements to Commercial, Medicaid, and Medicare cases. You will make clinical and/or benefit determinations to continue coverage of treatment, shape and modify treatment as appropriate, or issue an adverse benefit determination if applicable criteria are not met.

Work Environment

You’ll enjoy the flexibility to work remotely

• from anywhere within the U.S. as you take on some tough challenges. Schedule is Monday - Friday, standard business hours.

Primary Responsibilities

1. Handling psychological/neuropsychological testing service requests.
2. Managing standard outpatient treatments, including requests for extended sessions or single case agreements.
3. Providing state-specific Medicaid services (e.g., Psychosocial Rehabilitation, Targeted Case Management, Home-Based Habilitation, Supported Employment, etc.).
4. Overseeing Intensive Outpatient services for both Mental Health and Substance Abuse.
5. Participating in peer consultations, staff meetings, and trainings; entering determinations within federal, state, and local guidelines; and performing other duties as assigned by your manager.
6. Conducting non-MD clinical reviews such as testing requests, outpatient treatment plan reviews, ongoing outpatient care reviews, requests for non-standard outpatient services, and appeals of previously denied services or claims.

Qualifications

Required:

• Licensed doctoral level (Ph.D. or Psy.D.) Psychologist in your state of residence.
• Current license allowing full independent practice, unrestricted.
• 3+ years of post-licensure experience.
• Experience working with insurance agencies.
• Proficiency with Windows OS, Outlook, Word, and Excel.
• Ability to type proficiently while speaking on the phone.

Preferred:

• Experience in a managed care setting.
• Experience performing peer reviews.
• Experience with commercial, Medicaid, and Medicare.
• Knowledge of CPT and HCPCS codes.
• Clinical experience in higher levels of care, with children and adolescents, and with Substance Abuse diagnoses.
• Experience with Evidence-Based Treatment, advanced Excel and Access skills, and psychological/neuropsychological testing requests.
• Remote employees must adhere to UnitedHealth Group’s Telecommuter Policy.

Compensation and Benefits

The salary range for this role is $89,000 to $XXX,000 annually, based on full-time employment and factors such as location, education, experience, and certifications. In addition, UnitedHealth Group offers a comprehensive benefits package, incentive and recognition programs, equity stock purchase, and 401(k) contributions. Benefits are subject to eligibility requirements.

Application Process

This position will be posted for a minimum of 2 business days or until a sufficient candidate pool is collected. The posting may be removed earlier due to volume of applications.

Our Commitment

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We are committed to addressing health disparities and promoting health equity, especially for marginalized groups. We are an Equal Employment Opportunity employer and a drug-free workplace, requiring candidates to pass a drug test prior to employment.