Licensed Psychologist Peer Reviewer - ABA Autism - Remote - Remote Eligible

Psychologist Peer Reviewer For Applied Behavior Analysis - Autism Services

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 inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together.

The role of the Psychologist Peer Reviewer for Applied Behavior Analysis - Autism Services involves applying clinical and benefit plan criteria to service requests for initial and continued coverage of ABA treatment, shaping and modifying treatment as appropriate, and issuing an adverse benefit determination if treatment is not medically necessary.

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

Primary Responsibilities:

• ABA service requests for both Commercial and Medicaid Plans
• 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.
• The Psychologist Reviewer may conduct clinical reviews of the following type during a typical workday:
  • Clinical review of requests for ABA and Assessment services
  • Requests for Single Case Agreements
  • Appeals of previously denied services

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.

Required Qualifications:

• Licensed doctoral level Psychologist (Ph.D. or Psy.D.) Your license must be current, allow for full independent practice, and be unrestricted [You may be asked to obtain additional state licenses to meet growing business needs]
• 3+ years of post-licensure experience
• Clinical experience with Autism Spectrum Disorder
• Experience working with managed care entities
• 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
• Solid written and verbal communication and negotiation skills
• Ability to work well independently and collaborate with others on a clinical team
• Thrive in a fast-paced environment
• Solid computer skills, including facility with Windows OS, Outlook, Word, and Excel
• Ability to type proficiently, and for a significant portion of your day comfortably, while speaking on the phone
• Secure, private area of your home to set up an office, and access to a broadband ISP
• Available to work full-time during normal business hours Monday through Friday

Preferred Qualifications:

• BCBA, BCBA-D, LBA (in addition to being a licensed psychologist)
• APA accredited training and internship
• Applied Behavior Analysis training and/or experience
• 2+ years of experience testing children with Autism
• Experience working in a managed care setting
• Peer review experience with managed care
• Clinical experience with children and adolescents
• Behavior Modification expertise
• Advanced computer skills using Excel and Access Databases

All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy.

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The salary for this role will range from $89,900 to $160,600 annually based on full-time employment. We comply with all minimum wage laws as applicable.