Licensed Psychologist Peer Reviewer - ABA Autism - Remote

Overview

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 Behavioral Clinical Consultant, Peer Reviewer for ABA 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. Services reviewed may include, but are not limited to, the following:

• Applied Behavior Analysis service requests for both Commercial and Medicaid Plans

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.

• Clinical review of requests for ABA and Assessment services
• Requests for Single Case Agreements
• Appeals of previously denied services

You'll enjoy the flexibility to work remotely from anywhere within the U.S. as you take on some tough challenges. For all hires in the Minneapolis or Washington, D.C. area, you will be required to work in the office a minimum of four days per week.

You will 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.

• 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 diagnosing and treating people with Autism Spectrum Disorder
• Experience working with managed care entities
• Proven 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
• Proven written and verbal communication and negotiation skills
• Proven ability to work independently and collaborate with others on a clinical team
• Proven ability to thrive in a fast-paced environment
• Proven computer skills, including facility with Windows OS, Outlook, Word, and Excel
• Proven ability to type proficiently, and for a significant portion of your day comfortably, while speaking on the phone
• Proven secure, private area of your home to set up an office, and access to a broadband ISP
• Proven ability to work full-time during normal business hours Monday through Friday

• BCBA, BCBA-D, LBA (in addition to being a licensed psychologist)
• Applied Behavior Analysis training and/or experience
• APA accredited training and internship
• Psychologist licensed in AZ, CA, FL, GA, IN, KY, MA, MN, MS
• Clinical experience with children and adolescents
• Experience working in a managed care setting
• Peer review experience with managed care
• Proven Behavior Modification expertise
• Proven advanced computer skills using Excel and Access Databases

All employees working remotely will be required to adhere to United Health 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). No matter where or when you begin a career with us, you ll…