18 days old

Psychologist - Peer Reviewer (Telecommute)

Maryland Heights, MO 63043 Work Remotely
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  • Job Code
    882606
  • Jobs Rated
    89th

For those who want to invent the future of health care, here's your opportunity. We're going beyond counseling services and verified referrals to behavioral health programs integrated across the entire continuum of care. Join us and help people live healthier lives while doing your life's best work. (sm)

 

The role of the Psychologist - Peer Review for ALERT involves applying medical necessity and benefit plan criteria to commercialcases and making clinical determinations to continue coverage of medically necessary treatment, shaping and modifying treatment as appropriate, or issuing an adverse benefit determination if treatment is not medically necessary.

 

You'll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.

 

Primary Responsibilities:    

 

  • Traditional outpatient therapy, 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    
  • Psychological /Neuropsychological Testing service requests    
  • The Psychologist Reviewer will also participate in peer consultations, staff meetings, and trainings; be responsible for entering determinations within federal, state, and local guideline requirements; and perform of other duties as required by the reviewer's manager

 

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

 

  • Requests for psychological or neuropsychological testing
  • Review of outpatient treatment plans for services that on initial review, a Masters level employee is unable to continue coverage for
  • Review of ongoing outpatient care in cases where the member's length of stay exceeds normative standards
  • Requests for non - standard outpatient services (extended - length visits, an in - network accommodation)
  • 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 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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Jobs Rated Reports for Psychologist

Posted: 2020-09-02 Expires: 2020-10-09

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 (Telecommute)

UnitedHealth Group
Maryland Heights, MO 63043

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Psychologist
89th2018 - Psychologist
Overall Rating: 89/220
Median Salary: $97,740

Work Environment
Fair
122/220
Stress
High
167/220
Growth
Fair
90/220
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