Remote Florida Licensed Psychologist — Peer Review Specialist

Istss; Tampa (FL); Hybrid; USD 92,000 - 164,000; Full time

Job summary

UnitedHealth Group seeks a licensed psychologist (Ph.D. or Psy.D.) in Florida to serve as a Peer Reviewer for outpatient and ABA cases, applying clinical and benefit criteria to determine coverage.

Primary duties include clinical reviews, authorizations, appeals, and participating in staff meetings and trainings in a compliant, private home workspace. Florida residence and MS Office proficiency are required.

Qualifications

• Licensed psychologist (Ph.D. or Psy.D.) in Florida
• APA-accredited training and internship preferred
• Experience with insurance authorizations and peer reviews
• Proficient in MS Office applications (Word, Outlook, Teams, Excel, Access)
• Ability to manage multiple cases with strict turnaround times
• Must reside in Florida and have home office setup

Responsibilities

• Conduct clinical reviews including ABA and Medicaid/Medicare service requests
• Assist in service authorization decisions when initial review cannot authorize coverage
• Handle appeals of previously denied services
• Participate in consultations, meetings, and trainings
• Prepare and enter clinical determinations compliant with federal, state, and local requirements

Skills

Insurance authorizations experience

Written and verbal communication

Microsoft Office proficiency

Negotiation skills

Independently working

Ability to obtain additional licensure

Prioritization under time constraints

Remote work adaptability

Education

Ph.D. or Psy.D. in Psychology (Florida licensed)

APA-accredited internship

Tools

Microsoft Office (Word/Outlook/Teams/Excel/Access)

Job description

UnitedHealth Group seeks a licensed psychologist (Ph.D. or Psy.D.) in Florida to serve as a Peer Reviewer for outpatient and ABA cases, applying clinical and benefit criteria to determine coverage.

Primary duties include clinical reviews, authorizations, appeals, and participating in staff meetings and trainings in a compliant, private home workspace. Florida residence and MS Office proficiency are required.