Senior ABA Clinical Quality Specialist - | , IL

Site Visit Clinician

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.

Healthcare delivery is rapidly evolving, and within Optum Whole Health Solutions, the Site Visit Clinician supports provider quality, operational readiness, and consistent performance across the network. The role combines analytics, provider engagement, operational assessment, and quality improvement to strengthen the provider experience and reinforce key standards.

Work in this role is generally self directed and not highly prescribed. The clinician works through less structured and moderately complex issues, assesses provider needs, interprets requirements, and identifies solutions to non standard situations. The role involves translating developing concepts and quality expectations into practical site review activities and conducting analyses that support clear, actionable findings.

The Site Visit Clinician also serves as a resource to others by providing explanations on difficult issues, offering guidance as needed, and supporting colleagues with less experience. The clinician works with minimal guidance and seeks input only on the most complex tasks.

As a Site Visit Clinician, you will carry out the full lifecycle of ABA site reviews, including pre visit planning, data integration, onsite assessment, post visit reporting, and follow up on quality action plans. Since this work is early in its development and ABA quality standards continue to evolve, success requires comfort with ambiguity, critical thinking, and the ability to apply emerging standards in real provider settings.

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

Primary Responsibilities:

• Completes site visits
• Performs end to end coordination of ABA site reviews, from planning and data collection through onsite activities and post visit reporting
• Applies a disciplined, standardized approach to data integration, documentation, and quality verification to ensure consistency across provider evaluations
• Maintains and continuously improves the Integrated Checklist List (ICL) and related processes to ensure data completeness, clarity, and usability
• Works with less structured, more complex issues that arise from market, state, and practice variations and identifies solutions to non standard requests

• Pre visit planning, data analysis, and readiness
• Coordinates all preparatory activities and confirms that documentation and required data inputs are complete prior to the onsite review
• Collects, analyzes, interprets, and synthesizes quantitative and qualitative data, including ABA code utilization, provider and member long day analyses, and treatment intensity and supervision metrics
• Develops concise pre visit summaries that integrate Practice Management and PNI data, provider history, and centralized analytics
• Prepares tables, graphs, and interpretive narratives that translate analytic findings into practical review focus areas
• Organizes and uploads finalized pre visit documentation to shared systems for team access
• Participates in pre visit planning meetings to align expectations, roles, and logistics
• Works with minimal guidance and seeks guidance only for the most complex or ambiguous cases

• Onsite visit operations and provider facing interactions
• Serves as an onsite reviewer conducting structured interviews, observations, and operational assessments
• Interviews provider business and clinical leaders to assess compliance, quality, oversight, and workflow effectiveness; completes staff interviews to understand day to day operations
• Documents observations aligned with practice standards and program requirements
• Collaborates with a cross disciplinary site visit team, typically with at least two reviewers per site, and coordinates with state health plan executive leadership and departmental partners such as Network, Practice Management, Provider Network Integrity, and Data
• Solves moderately complex issues in real time and adjusts approach while maintaining standards
• Provides clear explanations and information to provider teams on difficult issues
• Acts as a resource for others with less experience and offers coaching on interview, observation, and documentation techniques

• Post visit reporting and quality improvement follow up
• Integrates pre visit data, provider documentation, interviews, observations, and Practice Management reports into clear post visit summaries
• Produces actionable written reports that synthesize qualitative and quantitative findings and translate policy and program concepts into practical provider actions
• Presents site visit results to internal leadership and to provider business and clinical leadership and provides explanations on complex findings
• Supports Quality Action Plans, including documentation, scheduling, and provider coaching; conducts follow up reviews to verify corrective actions and standards adherence
• Participates in internal debriefs and the onsite visit oversight committee to clarify findings, identify next steps, and recommend process refinements and training needs
• Impact spans operational, local business unit, and market levels

• Workload management and stakeholder alignment
• Plans and manages personal workload to align site review assignments with visit volume, provider complexity, and enterprise timelines
• Assesses and interprets stakeholder requirements and ensures day to day work aligns with market strategy and policy objectives in coordination with cross functional partners
• Escalates only the most complex technical, operational, or regulatory issues

• ABA Standards, Policy, and Provider Support
• Applies ABA standards of care (including CASP and accreditation-related expectations) and relevant clinical and operational policies during site reviews; translates standards into clear, practical feedback for providers
• Supports provider advocacy and value-based care goals by assessing treatment models, supervision structures, and utilization patterns with attention to quality, outcomes, and sustainability
• Maintains working familiarity with ABA industry trends, evolving standards, and payer expectations, incorporating these insights into site visit focus areas and quality improvement recommendations

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:

• Holds active Board Certified Behavior Analyst® (BCBA®) certification in good standing
• If required by the state of residence- Maintain unrestricted and in good standing licensure and certification
• Direct experience delivering applied behavior analysis (ABA) services in clinic, home, or community based settings and can independently apply this knowledge during site reviews
• Brings experience in provider quality oversight, operational review, clinical operations, or similar healthcare support functions involving moderately complex analytical and operational tasks
• Deep working understanding of Council of Autism Service Providers (CASP) standards of care and can interpret and apply these standards in varied provider environments
• Familiar with Autism Commission on Quality (ACQ) accreditation standards and able to translate accreditation concepts into practical assessment criteria during provider evaluations
• Demonstrates the ability to independently integrate data from multiple sources, interpret trends, and synthesize findings into clear, actionable insights
• Proven ability to communicate clearly in both written and verbal formats and can conduct structured interviews with provider leaders and staff at all levels
• Proven ability to manage multiple workflows with accuracy, attention to detail, and minimal guidance, including adjusting work in response to variable provider operations
• Proven capability of interpreting and presenting complex data, trends, and operational metrics in a way that supports decision making and quality improvement
• Proven solid interpersonal and collaboration skills, with the ability to work effectively with cross functional partners and serve as a resource for colleagues with less experience
• Ability to travel up to 40% to conduct onsite provider reviews and follow up activities

Preferred Qualifications:

• Experience in behavioral health operations, quality oversight, or provider management
• Experience providing training, creating and/or implementing tools, or processes to improve operational consistency
• Familiarity with implementing performance improvement frameworks and quality action planning

*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