Behavioral Clinical Program Manager

Optum; Eden Prairie (MN); Remote; USD 73,000 - 130,000; Full time

Benefits offered by this job

Comprehensive benefits package

Equity stock purchase

401k contribution

Incentive and recognition programs

Job summary

Optum is seeking a Behavioral Clinical Program Manager to lead analytics and collaboration with ABA providers nationwide. This remote role focuses on improving client outcomes, compliance, and billing practices while partnering with Care Advocacy and Network teams.

The role requires clinical licensure, BCBA certification, and extensive experience in managed care. You’ll work with senior leaders to drive performance improvements through audits, PIPs, and data analysis, with flexible telecommuting

Qualifications

• Licensed Master’s degree-level clinician in Psychology, Social Work, Counseling or Marriage or Family Counseling, Licensed Ph.D. level Psychologist
• Licenses must be independent, active and unrestricted
• Board certification as a Behavior Analyst and state licensure (when required in home state) (BCBA)
• 3+ years of Managed Care and/or Utilization Review experience in a Managed Care setting
• 3+ years of experience with CPT/HCPCS codes
• Intermediate level of proficiency with MS Office

Responsibilities

• Engage with senior leaders (e.g., CEO) at ABA facilities/providers
• Initiate interventions with ABA providers/facilities to enhance clinical outcomes, improve quality of care, and ensure appropriate billing and practice patterns
• Support high-performing ABA providers/facilities to maintain their performance standards
• Identify outliers through analysis of clinical outcomes data and utilization/claims data
• Conduct audits of ABA programs and provide feedback on results
• Measure improvements in program performance over time
• Adjust interventions as necessary to optimize outcomes
• Implement and monitor Performance Improvement Plans (PIPs) to address performance issues
• Support work of ABA onsite team with data analysis, provider interviews, report writing
• Collaborate with other Optum departments, including Care Advocacy, Affordability, Clinical Network Services, Program and Network Integrity, Legal, Onsite audit, and Quality Improvement

Skills

Psychology license

BCBA certification

Managed care experience

MS Office proficiency

Education

Master's degree in psychology/social work/counseling

Licensed PhD psychologist

Tools

MS Office

Excel

Job description

Improve the lives of others while Caring. Connecting. Growing together.

Job Description - Behavioral Clinical Program Manager (2388529)

Behavioral Clinical Program Manager - 2388529

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. Join us to startCaring. Connecting. Growing together.

The Applied Behavior Analysis (ABA) Practice Management Specialist must demonstrate strong clinical and analytic skills, as well as strong oral and written communication skills. They will be responsible for developing relationships with ABA providers and facilities, monitoring their clinical effectiveness and efficiency, and ensuring compliance with contractual obligations. This specialist will collaborate closely with senior leaders in ABA practices to optimize treatment outcomes for clients. Additionally, they will work with various teams, such as Care Advocacy Operations and Network Management, to achieve desired outcomes in ABA treatment for our members.

Location: Remote - Nationwide

You will enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.

Primary Responsibilities:

• Engage with senior leaders (e.g., CEO) at ABA facilities/providers
• Initiate interventions with ABA providers/facilities to enhance clinical outcomes, improve quality of care, and ensure appropriate billing and practice patterns
• Support high-performing ABA providers/facilities to maintain their performance standards
• Identify outliers through analysis of clinical outcomes data and utilization/claims data
• Conduct audits of ABA programs and provide feedback on results
• Measure improvements in program performance over time
• Adjust interventions as necessary to optimize outcomes
• Implement and monitor Performance Improvement Plans (PIPs) to address performance issues
• Support work of ABA onsite team with data analysis, provider interviews, report writing
• Collaborate with other Optum departments, including Care Advocacy, Affordability, Clinical Network Services, Program and Network Integrity, Legal, Onsite audit, and Quality Improvement

You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear directions on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Required Qualifications:

• Licensed Master's degree-level clinician in Psychology, Social Work, Counseling or Marriage or Family Counseling, Licensed Ph.D. level Psychologist
• Licenses must be independent, active and unrestricted
• Board certification as a Behavior Analyst and state licensure (when required in home state) (BCBA)
• 3+ years of Managed Care and/or Utilization Review experience in a Managed Care setting
• 3+ years of experience with CPT/HCPCS codes
• Intermediate level of proficiency with MS Office

Preferred Qualifications:

• 3+ years of knowledge or willingness to learn analytics software such as Microsoft Excel

*All Telecommuters 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 $72,800 to $130,000 annually based on full-time employment. We comply with all minimum wage laws as applicable.

Pursuant to the San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest and conviction records.

Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.

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.

UnitedHealth Group is committed to working with and providing reasonable accommodations to individuals with physical and mental disabilities. If you need special assistance or accommodation for any part of the application process, please call 1-866-566-8715 to be connected to Recruitment Services. Recruitment Services hours of operation are 7 a.m. to 7 p.m. CT, Monday through Friday.

UnitedHealth Group is a registered service mark of UnitedHealth Group, Inc. The UnitedHealth Group name with the dimensional logo, as well as the dimensional logo alone, are both service marks for the UnitedHealth Group, Inc.

Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.

UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.