Job Category:
Medical/Health
Reference Code:
315739
Position Type:
Full Time, Employee
UnitedHealth Group is among the most ambitious Fortune 25 companies you'll ever meet. Through our family of businesses, we're working to make the health care system perform better for more people, in more ways than ever.

Simply put, we think the entire system can be greater than it's ever been. And that drives us to work harder, aim higher, and expect more from one another.

Here, you'll be empowered to make an immediate impact for millions of others. And you'll achieve more than you ever expected. How does that fit with your plans?
Behavioral Clinical Consultant, Peer Review: Multiple locations (CA, MO, PA and MA)! - Multiple locations
UnitedHealth Group is an innovative leader in the health and well-being industry, serving more than 55 million Americans. Through our family of companies, we contribute outstanding clinical insight with consumer-friendly services and advanced technology to help people achieve optimal health.

OptumHealth is part of the family of companies that make UnitedHealth Group one of the leaders across most major segments of the US health care system.
 
If you want more meaning in your career - as a clinician or a business professional - think of OptumHealth as your calling.
 
By providing 60 million Americans with information, tools and solutions, we are helping to guide them through the health care system, financing their health care needs, and enabling them to achieve their personal health and well-being goals.
 
People in the position will be reviewing both inpatient and outpatient requests for neuropsychological testing.  The team consists of  Ph.D.'s and other clinical professionals who consult on various processes and programs, and those who manage development and implementation of medical expense initiatives.
 
Primary Responsibilities:
  • Performing peer to peer reviews regarding patient levels of care

  • Working with denials and appeals

  • Handling complaints by conducting clinical quality of care reviews, investigations and writing reports

  • Participating in multidisciplinary program reviews

  • Interfacing with the claims department to work through process issues in order to streamline

  • Talking to providers

  • Participating in local and national committees aimed at process improvement and overall health and wellness

  • Working with the internal staff on team wellness issues such as stress management

  • Advises leadership on improvement opportunities regarding medical expense programs and clinical activities that impact medical expense

  • Reviews the work of others

  • Develops innovative approaches and sought out as an expert

  • Serves as a leader/ mentor

At OptumHealth, you will perform within an innovative culture that's focused on transformational change in the health care system. You will leverage your skills across a diverse and multi-faceted business. And you will make contributions that will have an impact that's greater than you've ever imagined.


Required:
  • Must be a Licensed Ph.D. Level Psychologist

  • Current and unrestricted licensure in the state where the job is performed

  • Minimum of 1 year experience POST licensure

  • Strong communication and negotiation skills

  • Strong clinical competency

  • Strong computer skills, must be able to type in addition to navigating around a Windows environment

Preferred:


  • Managed Care experience

  • Experience interacting with the provider population

 
 
Diversity creates a healthier atmosphere: equal opportunity employer M/F/D/V
UnitedHealth Group is a drug-free workplace.  Candidates are required to pass a drug test before beginning employment. In addition, employees in certain positions are subject to random drug testing.
 



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Diversity creates a healthier atmosphere: equal opportunity employer M/F/D/V. UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.
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