Practice Management Specialist - ABA / Autism - Remote

Practice Management Specialist

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 start Caring. Connecting. Growing together.

The Practice Management Specialist must demonstrate strong clinical and analytic skills, strong oral and written communication skills and must be comfortable working closely with senior leaders at high volume facilities as well as provider groups and individual providers. The Facility Practice Specialist will be responsible for the development of relationships with Autism and Applied Behavioral Analysis (ABA) providers as well as other behavioral health providers, i.e., BCBAs, as appropriate. The Facility Practice Specialist will monitor their clinical effectiveness and efficiency, as well as compliance with contractual obligations. This Specialist will work closely with Care Advocacy Operations, Affordability and Network Management teams to affect desired outcomes with facilities/programs/providers as it relates to treatment for our membership.

The Specialist will partner with INN and OON Autism and ABA providers and other providers, i.e., BCBAs, as appropriate in the following manner:

Those facilities and/or groups/providers that operate outside of typical practice or billing patterns will be subject to a specific set of interventions. The Practice Management Specialist's role with these facilities/providers will be to coordinate a strategic effort that includes Clinical Operations, Network Services, Program and Network Integrity, and Affordability with the goal of designing and delivering interventions aimed at improving performance and outcomes.

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

Primary Responsibilities:

• Interface with senior leaders (e.g., CEO) at high volume facilities/groups or directly with providers, as indicated
• Communicate with facilities/groups/providers to initiate appropriate interventions focused on improvement of clinical outcomes and efficiency, as well as compliance with care advocacy processes and contractual obligations
• Support those high performing facilities and providers such that performance remains at a high level
• Identify outliers through analysis of clinical outcomes data, utilization/claims data, complaints, and compliance with care advocacy protocols
• Measure improvement of program/provider performance over time
• Monitor and report effectiveness of interventions
• Modify interventions as appropriate
• Initiate and monitor Corrective Action Plans (CAPs) as appropriate to affect performance
• Interface with other OHBS departments including Care Advocacy, Affordability, Clinical Network Services, Program and Network Integrity, and Quality Improvement

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:

• Independently Licensed Mental Health Clinician, Master's degree-level in Psychology, Social Work, Counseling or Marriage or Family Counseling, Licensed Ph.D. level Psychologist, or Registered Nurse with Behavioral Health experience
• Licenses and certifications must be independent, active and unrestricted
• Board Certified Behavioral Analyst Certification (BCBA)
• 3+ years of Managed Care and/or Utilization Review experience in a Managed Care setting with experience working with Autism and Applied Behavioral Analysis
• Solid computer skills at the intermediate level, proficiency with MS Office
• Dedicated space for home office set up and access to high speed internet services

Preferred Qualifications:

• Post-licensure direct clinical experience
• Knowledge of the public sector, i.e., Medicaid
• Solid analytical skills with knowledge of or willingness to learn analytics software such as Microsoft Excel
• Proven solid communication skills, written and verbal
• Demonstrates excellent time management and prioritization skills
• Proven capacity to provide solutions for non - standard and / or complex issues solutions
• Proven ability to balance contractual and clinical considerations
• Proven ability to work in a self - directed manner, seeking guidance on only the most complex tasks
• Proven ability to establish and maintain strategic relationships with facilities senior leadership teams

Careers with Optum. Our objective is to make health care simpler and more effective for everyone. With our hands at work across all aspects of health, you can play a role in creating a healthier world, one insight, one connection and one person at a time. We bring together some of the greatest minds and ideas to take health care to its fullest potential, promoting health equity and accessibility. Work with diverse, engaged and high-performing teams to help solve important challenges.

California, Colorado, Connecticut, Nevada, New York, Rhode Island, or Washington Residents Only: The salary range for California, Colorado, Connecticut, Nevada, New York, Rhode Island or Washington residents is $67,800 to $133,100. Pay is based on several factors including but not limited to education, work experience, certifications, etc. In addition to your salary, UnitedHealth Group offers 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 UnitedHealth Group, you'll find a far-reaching choice of benefits and incentives.

• All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy

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.

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.