Autism Care Advocate - ABA Utilization Management - Remote

Okpsych; Eden Prairie (MN); Hybrid; USD 60,000 - 107,000; Full time

Job summary

UnitedHealth Group is seeking a remote role to review medical necessity criteria for Applied Behavior Analysis treatment requests and to provide autism education to parents and caregivers.

This telephonic, queue-based position operates 7am-7pm CST, Monday to Friday, with the flexibility to work remotely from anywhere in the U.S. It emphasizes collaboration with providers and case management to coordinate benefits.

Qualifications

• Active, unrestricted license: clinical mental health, LBA, or BCBA.
• 2+ years in a behavioral health environment.
• Experience with children/adolescents on the autism spectrum.
• Proficient in Microsoft Office (Teams, Word, Outlook).
• Dedicated, distraction-free workspace with high-speed internet.

Responsibilities

• Review diagnostic evaluations to validate diagnoses.
• Obtain clinical information from providers on ABA requests.
• Determine if additional ABA sessions are medically necessary.
• Manage outpatient cases throughout the treatment plan.
• Coordinate benefits and transitions between care areas.
• Identify ways to add value to treatment plans and consult with staff.
• Provide education and resources to parents/caregivers on ABA and benefits.
• Quote benefits and provide referrals as needed.

Skills

2+ years of experience in a behavioral

Experience with autism spectrum

Tools

Microsoft Office Suite (Teams, Word, Outlook)

Job description

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 inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together.

In this role, you will work directly with providers to review medical necessity criteria for Applied Behavior Analysis (ABA) treatment requests and provide autism education and resources to parents and caregivers.

This is a telephonic, queue-based position with a structured schedule between the business hours of 7am - 7pm CST, Monday - Friday.

You’ll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges.

Primary Responsibilities:

• Review comprehensive diagnostic evaluations to ensure valid diagnoses
• Obtain clinical information from providers on Applied Behavior Analysis treatment requests
• Determine if additional clinical treatment sessions for Applied Behavior Analysis are medically necessary in accordance with appropriate level of care guidelines
• Manage outpatient cases throughout the entire treatment plan
• Coordinate benefits and transitions between various areas of care including case management
• Identify ways to add value to treatment plans and consult with facility staff / outpatient care providers
• Provide education and resources to parents/caregivers specific to Applied Behavior Analysis treatment and/or their benefit plan
• Quote benefits and provide referrals as needed

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.

Required Qualifications:

• One of the following credentials; must be active and unrestricted:
  • Independent clinical mental health license (Social Worker, Counselor, Therapist, or Psychologist)
  • Licensed Behavior Analyst (LBA)
  • Board Certified Behavior Analyst (BCBA) if the LBA is not offered in your state
• 2+ years of experience in a related behavioral health environment
• Experience working with children and/or adolescents on the autism spectrum
• Proficient in Microsoft Office Suite including Teams, Word, and Outlook
• Dedicated, distraction-free workspace and access to high-speed internet in home

Preferred Qualifications:

• ABA certification
• Managed Care experience
• Utilization Management experience

*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). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $60,200 - $107,400 annually based on full-time employment. We comply with all minimum wage laws as applicable.

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. 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. Candidates are required to pass a drug test before beginning employment.