Psychologist, Peer Reviewer - New York City, NY

New York HARP Program!  Licensed Psychologist!  Medicaid!    For those who want to invent the future of health care, here's your opportunity. We're going beyond counseling services and verified referrals to behavioral health programs integrated across the entire continuum of care. Join us and help people live healthier lives while doing your life's best work.(sm)   As the chosen candidate, you will be assisting people with maintaining their maximum independence in the community, self-sufficiency and understanding of the appropriate use of Home and Community Based Services (HCBS).   This is a work from home (telecommuting) opportunity.   Responsibilities of the Peer Reviewer will include:  Reviewing provider requests for psychological testingConducting peer-to-peer reviews with psychologists and other behavioral health providers to assure that accreditation standards, level-of-care guidelines and generally accepted clinical practices are followedConducting clinical reviews of contracted provider clinical records as requestedParticipating in Quality assurance activities and audits as needed Providing care management for inpatient and outpatient psychiatric and substance abuse cases through telephonic reviewsCompleting call monitoring and documentation audits to determine compliance with clinical guidelines, policies and procedures, and operational workflowsEntering certifications and documentation into the care management systems in a timely mannerMeeting internal and external business requirements for specific books of business, including turnaround times, peer-to-peers, and authorization decisionsAssisting the clinical management team with clinical consultation, staff training and case conferencesProviding consultation to Optum management and staff regarding such issues as clinical standards, policies, procedures, recovery and resiliency and best practicesPerforming other duties as requested by supervisor

Required:A Ph.D. or Psy.D. in Psychology is REQUIRED for this roleMust have a current, unrestricted licensure in the State of New YorkExperience with psychological testing Demonstrated understanding of the clinical application of the principles of engagement, empowerment, rehabilitation and recoveryIntermediate computer proficiency, must be able to utilize multiple systems within a Windows based environment 2 years of experience in the delivery of rehabilitation services for individuals with mental and substance abuse conditionsMust have the ability to lead, teach and mentor others (i.e. less experienced clinicians) Preferred Assets:Background in Utilization ReviewExperience in Managed Care  Experience working with dual diagnosis: behavioral health and substance abuse Experience in a telephonic role is a plus!  Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make the health system work better for everyone. So when it comes to how we use the world's large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to do your life's best work.SM
Diversity creates a healthier atmosphere: All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, protected veteran status, or disability status.UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.Job Keywords: Ph.D., Psy.D., Psychologist, Psychology, Peer Review, NY Harp, HCBS, Medicaid, Psychological Testing, Behavioral Health, Mental Health, Licensed, NY, New York, New York City, NYC, Syracuse, Manhattan, Managed Care, Healthcare, UHG, UnitedHealth Group, Optum, Public Sector, telecommuting, work from home.