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.Hours: Monday through Friday 8AM-4:30PM CSTYou’ll enjoy the flexibility to work remotely from anywhere within the U.S. as you take on some tough challenges.Primary Responsibilities:
Make determinations of medical necessity/clinical appropriateness of treatment
Assist in the development and implementation of clinical policy, guidelines and applications
Regularly contact providers whose treatment determinations indicate a trend that varies with their peers and community
Be knowledgeable on and apply all necessary regulatory requirements for assigned regions
Appropriate utilization management (prospective, concurrent and retrospective) and implementation of healthcare affordability initiatives in all the UnitedHealthcare regions
Take initiative to control utilization trends without losing sight of quality and outcomes for health care consumers
Implement specific strategies that improve the quality and outcomes of care for consumers
Support many types of health plan structures (Fully Insured, Medicare, Medicaid)
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:
Current and Unrestricted license to practice Occupational Therapy in your state of residence
5+ years of experience working in adult orthopedic environments
Proficiency in MS Office (Outlook, Word, Excel, MS Teams)
Proficient knowledge of practice guidelines, including office procedures, current research and scope of practice
Proven ability to interpret guidelines, research, etc. in the context of traditional Occupational Therapy practice
Proven ability to be consultative with others including supervisory, clinical and non-clinical professionals
Dedicated, distraction free workplace with access to high speed internet from home (Broadband cable, Fiber or DSL)
Preferred Qualifications:
3+ years of clinical experience performing case review
1+ years of experience as an Occupational Therapist working with the adult neuro and/or geriatric population
Experience in a managed care environment (health plan, medical group, etc.)
All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter PolicyCalifornia, Colorado, Connecticut, Hawaii, Nevada, New York, New Jersey, Rhode Island, Washington or Washington, D.C. Residents Only: The salary range for this role is $70,200 to $137,800 annually. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. 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.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.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.