1+ months

Psychologist Peer Reviewer - ABA Services - Mississippi or Telecommute - 901993

Meridian, MS 39301 Work Remotely
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  • Job Code
    901993
  • Jobs Rated
    81st

The role of the Behavioral Clinic Consultant, Peer Reviewer for ALERT ABA Services involves applying medical necessity and benefit plan criteria to service requests for initial and continued coverage of ABA treatment, shaping and modifying treatment as appropriate, or issuing an adverse benefit determination if treatment is not medically necessary. Services reviewed may include, but are not limited to, the following:

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  • Applied Behavior Analysis service requests for both Commercial and Medicaid Plans
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Youll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.

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The Peer Reviewer will also 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 by the reviewers manager.

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The Psychologist Reviewer may conduct clinical reviews of the following type during a typical workday:

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  • Review of requests for ABA and Assessment service authorization that upon initial review, a Masters level employee is unable to authorize
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  • Requests for Single Case Agreements
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  • Appeals of previously denied services
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Youll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

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Required Qualifications:

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  • You must be a licensed doctoral level Psychologist (Ph.D. or Psy.D.) in your state of residence. Your license must be current, allow for full independent practice, and be unrestricted
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  • Ability to obtain additional state licenses to meet growing business needs
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  • 3+ years post-licensure experience
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  • Experience with Applied Behavior Analysis services and the treatment of Autism Spectrum disorders
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  • 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
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  • Solid written and verbal communication and negotiation skills
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  • Ability to work well independently and collaborate with others on a clinical team
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  • Experience working with insurance agencies
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  • Solid computer skills, including facility with Windows OS, Outlook, Word, and Excel
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  • Ability to type proficiently, and for a significant portion of your day comfortably, while speaking on the phone
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  • You have a secure, private area of your home to set up an office, and access to a broadband ISP
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  • Available to work during normal business hours full-time Monday through Friday
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  • If you need to enter a work site for any reason, you will be required to screen for symptoms using the ProtectWell mobile app, Interactive Voice Response (i.e., entering your symptoms via phone system) or a similar UnitedHealth Group-approved symptom screener. When in a UnitedHealth Group building, employees are required to wear a mask in common areas. In addition, employee must comply with any state and local masking orders
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Preferred Qualifications:

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  • Licensed BCBA
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  • Psychologist licensed in the state of Mississippi
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  • APA accredited training and internship
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  • Prior experience working in a managed care setting
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  • Prior peer review experience with managed care
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  • Clinical experience with children and adolescents
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  • Advanced computer skills using Excel and Access Databases
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  • Enjoy a fast-paced environment
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Do you have compassion and a passion to help others? Transforming healthcare and millions of lives as a result starts with the values you embrace and the passion you bring to achieve your lifes best work.(sm)

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*All Telecommuters will be required to adhere to UnitedHealth Groups Telecommuter Policy

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Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.

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

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Keywords: ABA, Autism, Psychologist, Ph.D., Psy.D. Medicaid, Peer Reviewer, Telecommute

Jobs Rated Reports for Psychologist

Posted: 2020-12-10 Expires: 2021-02-13

UnitedHealth Group is the most diversified health care company in the United States and a leader worldwide in helping people live healthier lives and helping to make the health system work better for everyone.

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Psychologist Peer Reviewer - ABA Services - Mississippi or Telecommute - 901993

UnitedHealth Group
Meridian, MS 39301

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Psychologist
81st2019 - Psychologist
Overall Rating: 81/199
Median Salary: $79,010

Work Environment
Fair
111/220
Stress
High
173/220
Growth
Good
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