Psychologist Reviewer (Remote)

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 diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. The role of the Psychologist Peer Review involves applying clinical criteria and benefit plan requirements to Commercial, Medicaid, and Medicare cases, and making clinical and /or benefit determinations to continue coverage of treatment, shaping and modifying treatment as appropriate, or issuing an adverse benefit determination if applicable criteria is not met. You'll enjoy the flexibility to work remotely * from anywhere within the U.Schedule is Monday - Friday, standard business hours. **Psychological /Neuropsychological Testing service requests + Psychosocial Rehabilitation, Targeted Case Management, Home Based Habilitation, Supported Employment, etc.) + Intensive Outpatient services for both Mental Health and Substance Abuse + 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 Non-MD clinical reviews of the following type during a typical workday: Requests for psychological or neuropsychological testing + Review of outpatient treatment plans for services that are sent for Peer Review that do not appear to meet clinical criteria and/or when there are concerns about the quality of care + Requests for non - standard outpatient services (extended - length visits, an in - network accommodation, intensive outpatient program with no MD involvement) + 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. **Psychologist in your state of residence + Computer skills, including facility with Windows OS, Outlook, Word, and Excel + Ability to type proficiently while speaking on the phone **Experience with commercial, Medicaid and Medicare lines of business + Clinical experience with children and adolescents + Experience with Psychological /Neuropsychological Testing service requests + 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. **Application Deadline:** This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission._ _UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations._ _UnitedHealth Group is a drug - free workplace.