Behavioral Clinical Program Manager
About The Position
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 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. Schedule: Monday to Friday, 8 AM- 5 PM, flexible time zone Location: Remote - Nationwide You will enjoy the flexibility to telecommute from anywhere within the U.S. as you take on some tough challenges.
Requirements
- 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
Nice To Haves
- 3+ years of knowledge or willingness to learn analytics software such as Microsoft Excel
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
Benefits
- comprehensive benefits package
- incentive and recognition programs
- equity stock purchase
- 401k contribution
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
