Licensed Psychologist, Peer Reviewer - Remote in Florida
$91,700–$163,700 year
On-siteKissimmee, Florida, United States
Job Summary
Conduct clinical reviews of service authorization requests, ongoing outpatient care exceeding normative standards, non-standard service requests, and appeals of denied services. Compose and enter clinical determinations that comply with federal, state, and local requirements while participating in consultations, staff meetings, and trainings. Prioritize multiple demands within strict turnaround time requirements while tracking state and business nuances for cases involving Medicaid, Medicare, and commercial plans. Maintain a standard Monday through Friday schedule from 8:30am to 5pm CST while working remotely from a secure home office 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
- Must be able to work a standard schedule: Monday through Friday (8:30am to 5pm CST)
- Must be located in Florida
- Must adhere to UnitedHealth Group's Telecommuter Policy
- Candidates are required to pass a drug test before beginning employment
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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