Remote Licensed Psychologist – ABA Peer Reviewer

Pennsylvania Psychological Association; Maryland Heights (MO); Remote; USD 92,000 - 164,000; Full time

Benefits offered by this job

Telecommuter policy

Job summary

UnitedHealth Group is seeking a Licensed Psychologist to serve as a Peer Reviewer for Applied Behavior Analysis (ABA) Services. The role evaluates initial and ongoing ABA requests for commercial and Medicaid plans, applying clinical criteria and plan requirements in a fast-paced setting.

Responsibilities include peer-to-peer discussions with providers, drafting determinations, handling single-case agreements, and participating in training activities.

Qualifications

• Licensed doctoral level Psychologist (Ph.D. or Psy.D.) with 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 for multiple states/cases
• Ability to work independently and on a clinical team
• Strong written and verbal communication and negotiation skills
• Availability to work full-time during standard business hours

Responsibilities

• Review initial and continued-service requests for ABA treatment and assessment services 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
• Compose and enter clear clinical determinations, including adverse determinations when needed
• Review requests for single-case agreements and appeals of denied services
• Participate in peer consultations, staff meetings, and training activities
• Perform other duties as assigned

Skills

MS Office

Typing proficiency

Time management

Communication skills

Independent worker

Team collaboration

Full-time availability

Education

PhD or PsyD in Psychology

Tools

Excel

Access

Job description

UnitedHealth Group is seeking a Licensed Psychologist to serve as a Peer Reviewer for Applied Behavior Analysis (ABA) Services. The role evaluates initial and ongoing ABA requests for commercial and Medicaid plans, applying clinical criteria and plan requirements in a fast-paced setting.

Responsibilities include peer-to-peer discussions with providers, drafting determinations, handling single-case agreements, and participating in training activities.