Behavioral Clinical Program Manager

Optum is hiring a Behavioral Clinical Program Manager to improve clinical outcomes and care quality across Applied Behavior Analysis (ABA) providers and facilities. The role builds provider relationships, analyzes performance data, conducts audits, and implements interventions and performance improvement plans in collaboration with internal teams.

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

Preferred

• 3+ years of knowledge or willingness to learn analytics software such as Microsoft Excel
• Analytics Software
• Microsoft Excel
• Willingness to Learn

Benefits

• Remote work from anywhere within the U.S.
• Comprehensive benefits package
• Incentive and recognition programs
• Equity stock purchase
• 401k contribution

Company

• Health care services and prescription management
• Eden Prairie, Minnesota, USA
• https://nm.optum.com/
• Founded in 1985
• 10001+ employees

Qualifications

• strong clinical and analytic skills
• strong oral and written communication skills
• 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
• Strong clinical and analytic skills
• Strong oral and written communication skills
• 3+ years of knowledge or willingness to learn analytics software such as Microsoft Excel

Required skills

• , Applied Behavior Analysis (ABA), Board Certified Behavior Analyst (BCBA), Independent Clinical Licensure, Managed Care, Utilization Review, CPT/HCPCS Coding

Experience

• 3+ years