Remote Behavioral Health 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

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