Licensed Psychologist, Peer Reviewer - Remote in Florida
$91,700–$163,700 year
On-siteBakersfield, California, United States
EXPIREDBakersfield, California, United StatesOn-siteFull Time$91,700–$163,700 yearDoctorate Or Professional DegreeLarge
Full TimeDoctorate Or Professional DegreeLarge
Job Summary
Conduct clinical reviews of service authorization requests, ongoing outpatient care, and non-standard services such as ABA and psychosocial rehabilitation. Compose and enter clinical determinations that comply with federal, state, and local requirements while participating in consultations, staff meetings, and trainings. Handle appeals of previously denied services and apply criteria to Commercial, Medicaid, and Medicare cases. Work a standard Monday through Friday schedule (8:30am to 5pm CST) from a remote location in Florida.
Required Qualifications
- Independently licensed doctoral level Psychologist (Ph.D. or Psy.D.) in the state of Florida
- Ability to obtain additional state licensures to meet growing business needs
- 3+ years of post-licensure experience
- Experience working with insurance companies to acquire authorizations, file claims, conduct peer reviews, etc.
- Advanced proficiency using Microsoft Office Applications (Word, Outlook, TEAMS, Excel, and Access Database)
- Proven ability to prioritize multiple demands within strict turnaround time requirements and track multiple state/business nuances for cases reviewed
- Proven ability to work independently and collaborate with others on a clinical team
- Proven advanced written and verbal communication and negotiation skills
- Secure, private area of your home to set up an office, and access to a broadband ISP
- Permanent residence in the state of Florida
- UnitedHealth Group's Telecommuter Policy
Desired Qualifications
- APA accredited training and internship
- Experience working in a managed care setting
- Experience with Public Sector (Medicaid/Medicare) services and HCPC codes/services
- Clinical experience with Substance Abuse diagnoses
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