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Job Details
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 CST You’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
- Responsible for 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)
- 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
- Ability to interpret guidelines, research, etc. in the context of traditional Occupational Therapy practice
- 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)
- 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.)
About the Company
UnitedHealth Group
Minnetonka, MN, United States
UnitedHealth Group is a health care and well-being company that’s dedicated to improving the health outcomes of millions worldwide. We are... Read more