Licensed Psychologist - Peer Reviewer - Remote anywhere USA

Lensa; Houston (TX); Remote; USD 80,000 - 100,000; Full time

Job summary

A leading healthcare organization is seeking a Licensed Psychologist for remote peer review roles across the USA. The position involves evaluating treatment plans and making clinical determinations while working with various insurance agencies. Candidates should have a Ph.D. or Psy.D. and relevant experience in the field. This role offers flexibility and a comprehensive benefits package.

Benefits

Comprehensive benefits package

401k contribution

Equity stock purchase

Qualifications

• 3+ years of post-licensure experience.
• Licensed doctoral level Psychologist in state of residence.

Responsibilities

• Conduct psychological/neuropsychological testing and reviews.
• Make clinical determinations for treatment coverage.

Skills

Psychological Testing

Clinical Reviews

Computer Skills

Education

Ph.D. or Psy.D.

Tools

Windows OS

Excel

Job description

Licensed Psychologist - Peer Reviewer - Remote anywhere USA

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Lensa is the leading career site for job seekers at every stage of their career. Our client, UnitedHealth Group, is seeking professionals. Apply via Lensa today!

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.

The role of the Psychologist Peer Review involves applying clinical criteria and benefit plan requirements to Commercial, Medicaid, and Medicare cases, making clinical and/or benefit determinations to continue coverage of treatment, shaping and modifying treatment as appropriate, or issuing an adverse benefit determination if applicable criteria are not met.

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

• Psychological / Neuropsychological Testing service requests
• Standard outpatient treatment, including requests for extended length sessions or single case agreements
• State-specific Medicaid services (e.g., Psychosocial Rehabilitation, Targeted Case Management, Home Based Habilitation, Supported Employment, etc.)
• Intensive Outpatient services for both Mental Health and Substance Abuse
• The Psychologist Reviewer will participate in peer consultations, staff meetings, and trainings; be responsible for entering determinations within federal, state, and local guideline requirements; and perform other duties as required by the manager
• The Psychologist may conduct Non-MD clinical reviews of requests for psychological or neuropsychological testing, outpatient treatment plans, ongoing outpatient care, and requests for non-standard outpatient services, including appeals of previously denied services or claims for outpatient Non-MD services up to and including Intensive Outpatient Programming.

You’ll be rewarded and recognized for your performance in an environment that challenges you and provides clear development pathways. Required Qualifications

• Licensed doctoral-level (Ph.D. or Psy.D.) Psychologist in your state of residence
• Current License, allowing full independent practice, and unrestricted (additional state licenses may be required)
• 3+ years of post-licensure experience
• Experience working with insurance agencies
• Computer skills, including Windows OS, Outlook, Word, and Excel
• Proficient typing while speaking on the phone

Preferred Qualifications

• Experience in a managed care setting
• Experience performing Peer Reviews
• Experience with commercial, Medicaid, and Medicare lines of business
• Knowledge of CPT and HCPCS codes
• Clinical experience in higher levels of care, children, adolescents, Substance Abuse diagnoses, and Evidence-Based Treatment
• Advanced skills in Excel and Access Databases
• Experience with Psychological / Neuropsychological Testing service requests
• Adherence to UnitedHealth Group’s Telecommuter Policy for remote employees

The salary range is $89,800 to $176,700 annually, based on full-time employment, with benefits including comprehensive packages, incentive programs, equity stock purchase, and 401k contributions. The application deadline is a minimum of 2 business days or until a sufficient candidate pool is reached.

At UnitedHealth Group, our mission is to help people live healthier lives and improve health equity, addressing disparities among marginalized groups. We are an Equal Employment Opportunity employer and a drug-free workplace requiring pre-employment drug testing.