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Job Field: Office Jobs
Location: San Francisco, CA
Salary: $Not stated

JOB SUMMARY:

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<tr><td valign="top" width="450"><b>Title: Psychologist, Peer Reviewer! License Required! San Francisco!Location: US-CA-San FranciscoJob Number:_507140Clinical Consultant, Peer Reviewer! San Francisco, CA! The licensed psychologist in this position will be reviewing both Inpatient and Outpatient requests for Neuropsychological testing. The peer review team consists of doctorate level licensed psychologists and other clinical professionals who consult on various processes and programs, and those who manage development and implementation of medical expense initiatives.***Possible telecommuting option based on business needs***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* Consulting with 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/ mentorQualifications:Required:* Must be a Licensed Ph.D. or Psy.D. Level Psychologist* Current and unrestricted licensure must be from the State of CA* Minimum1 year of mental health experience POST licensure* Strong communication and negotiation skills* Strong writing skills* Strong clinical competency* Strong computer skills, must be able to type in addition to navigating around a Windows environmentPreferred:* Managed Care and/or health plan experience* Experience interacting with the provider population* Utilization Review experienceOptumHealth 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.OptumHealth helps nearly 60 million Americans live their lives to the fullest by educating them about their symptoms, conditions and treatments; helping them to navigate the system, finance their health care needs and stay on track with their health goals. No other business touches so many lives in such a positive way. And we do it all with every action focused on our shared values of Integrity, Compassion, Relationships, Innovation & Performance.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.Diversity creates a healthier atmosphere: equal opportunity employer M/F/D/VUnitedHealth 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.Job: Behavioral Clinical Consulting

KEY REQUIREMENTS:

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