Senior ABA Clinical Quality Specialist - Hybrid

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<p><span style="font-family:Tahoma, Geneva, sans-serif;font-size:10px;">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 inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start<strong> Caring. Connecting. Growing together.</strong></span></p><p><br><span style="font-family:Tahoma, Geneva, sans-serif;font-size:10px;">Healthcare delivery is rapidly evolving, and within Optum Whole Health Solutions, the Site Visit Clinician supports provider quality, operational readiness, and consistent performance across the network. The role combines analytics, provider engagement, operational assessment, and quality improvement to strengthen the provider experience and reinforce key standards.</span></p><p><br><span style="font-family:Tahoma, Geneva, sans-serif;font-size:10px;">Work in this role is generally self directed and not highly prescribed. The clinician works through less structured and moderately complex issues, assesses provider needs, interprets requirements, and identifies solutions to non standard situations. The role involves translating developing concepts and quality expectations into practical site review activities and conducting analyses that support clear, actionable findings.</span></p><p><br><span style="font-family:Tahoma, Geneva, sans-serif;font-size:10px;">The Site Visit Clinician also serves as a resource to others by providing explanations on difficult issues, offering guidance as needed, and supporting colleagues with less experience. The clinician works with minimal guidance and seeks input only on the most complex tasks.</span></p><p><br><span style="font-family:Tahoma, Geneva, sans-serif;font-size:10px;">As a Site Visit Clinician, you will carry out the full lifecycle of ABA site reviews, including pre visit planning, data integration, onsite assessment, post visit reporting, and follow up on quality action plans. Since this work is early in its development and ABA quality standards continue to evolve, success requires comfort with ambiguity, critical thinking, and the ability to apply emerging standards in real provider settings.</span></p><p><br><span style="font-family:Tahoma, Geneva, sans-serif;font-size:10px;">You’ll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges.</span></p><p><br><span style="font-family:Tahoma, Geneva, sans-serif;font-size:10px;"><strong>Primary Responsibilities:</strong></span></p><p><span style="font-family:Tahoma, Geneva, sans-serif;font-size:10px;">Completes site visits</span></p><ul><li><span style="font-family:Tahoma, Geneva, sans-serif;font-size:10px;">Performs end to end coordination of ABA site reviews, from planning and data collection through onsite activities and post visit reporting</span></li><li><span style="font-family:Tahoma, Geneva, sans-serif;font-size:10px;">Applies a disciplined, standardized approach to data integration, documentation, and quality verification to ensure consistency across provider evaluations</span></li><li><span style="font-family:Tahoma, Geneva, sans-serif;font-size:10px;">Maintains and continuously improves the Integrated Checklist List (ICL) and related processes to ensure data completeness, clarity, and usability</span></li><li><span style="font-family:Tahoma, Geneva, sans-serif;font-size:10px;">Works with less structured, more complex issues that arise from market, state, and practice variations and identifies solutions to non standard requests</span></li></ul><p><span style="font-family:Tahoma, Geneva, sans-serif;font-size:10px;">Pre visit planning, data analysis, and readiness</span></p><ul><li><span style="font-family:Tahoma, Geneva, sans-serif;font-size:10px;">Coordinates all preparatory activities and confirms that documentation and required data inputs are complete prior to the onsite review</span></li><li><span style="font-family:Tahoma, Geneva, sans-serif;font-size:10px;">Collects, analyzes, interprets, and synthesizes quantitative and qualitative data, including ABA code utilization, provider and member long day analyses, and treatment intensity and supervision metrics</span></li><li><span style="font-family:Tahoma, Geneva, sans-serif;font-size:10px;">Develops concise pre visit summaries that integrate Practice Management and PNI data, provider history, and centralized analytics</span></li><li><span style="font-family:Tahoma, Geneva, sans-serif;font-size:10px;">Prepares tables, graphs, and interpretive narratives that translate analytic findings into practical review focus areas</span></li><li><span style="font-family:Tahoma, Geneva, sans-serif;font-size:10px;">Organizes and uploads finalized pre visit documentation to shared systems for team access</span></li><li><span style="font-family:Tahoma, Geneva, sans-serif;font-size:10px;">Participates in pre visit planning meetings to align expectations, roles, and logistics</span></li><li><span style="font-family:Tahoma, Geneva, sans-serif;font-size:10px;">Works with minimal guidance and seeks guidance only for the most complex or ambiguous cases</span></li></ul><p><span style="font-family:Tahoma, Geneva, sans-serif;font-size:10px;">Onsite visit operations and provider facing interactions</span></p><ul><li><span style="font-family:Tahoma, Geneva, sans-serif;font-size:10px;">Serves as an onsite reviewer conducting structured interviews, observations, and operational assessments</span></li><li><span style="font-family:Tahoma, Geneva, sans-serif;font-size:10px;">Interviews provider business and clinical leaders to assess compliance, quality, oversight, and workflow effectiveness; completes staff interviews to understand day to day operations</span></li><li><span style="font-family:Tahoma, Geneva, sans-serif;font-size:10px;">Documents observations aligned with practice standards and program requirements</span></li><li><span style="font-family:Tahoma, Geneva, sans-serif;font-size:10px;">Collaborates with a cross disciplinary site visit team, typically with at least two reviewers per site, and coordinates with state health plan executive leadership and departmental partners such as Network, Practice</span></li><li><span style="font-family:Tahoma, Geneva, sans-serif;font-size:10px;">Management, Provider Network Integrity, and Data</span></li><li><span style="font-family:Tahoma, Geneva, sans-serif;font-size:10px;">Solves moderately complex issues in real time and adjusts approach while maintaining standards</span></li><li><span style="font-family:Tahoma, Geneva, sans-serif;font-size:10px;">Provides clear explanations and information to provider teams on difficult issues</span></li><li><span style="font-family:Tahoma, Geneva, sans-serif;font-size:10px;">Acts as a resource for others with less experience and offers coaching on interview, observation, and documentation techniques</span></li></ul><p><span style="font-family:Tahoma, Geneva, sans-serif;font-size:10px;">Post visit reporting and quality improvement follow up</span></p><ul><li><span style="font-family:Tahoma, Geneva, sans-serif;font-size:10px;">Integrates pre visit data, provider documentation, interviews, observations, and Practice Management reports into clear post visit summaries</span></li><li><span style="font-family:Tahoma, Geneva, sans-serif;font-size:10px;">Produces actionable written reports that synthesize qualitative and quantitative findings and translate policy and program concepts into practical provider actions</span></li><li><span style="font-family:Tahoma, Geneva, sans-serif;font-size:10px;">Presents site visit results to internal leadership and to provider business and clinical leadership and provides explanations on complex findings</span></li><li><span style="font-family:Tahoma, Geneva, sans-serif;font-size:10px;">Supports Quality Action Plans, including documentation, scheduling, and provider coaching; conducts follow up reviews to verify corrective actions and standards adherence</span></li><li><span style="font-family:Tahoma, Geneva, sans-serif;font-size:10px;">Participates in internal debriefs and the onsite visit oversight committee to clarify findings, identify next steps, and recommend process refinements and training needs</span></li><li><span style="font-family:Tahoma, Geneva, sans-serif;font-size:10px;">Impact spans operational, local business unit, and market levels</span></li></ul><p><span style="font-family:Tahoma, Geneva, sans-serif;font-size:10px;">Workload management and stakeholder alignment</span></p><ul><li><span style="font-family:Tahoma, Geneva, sans-serif;font-size:10px;">Plans and manages personal workload to align site review assignments with visit volume, provider complexity, and enterprise timelines</span></li><li><span style="font-family:Tahoma, Geneva, sans-serif;font-size:10px;">Assesses and interprets stakeholder requirements and ensures day to day work aligns with market strategy and policy objectives in coordination with cross functional partners</span></li><li><span style="font-family:Tahoma, Geneva, sans-serif;font-size:10px;">Escalates only the most complex technical, operational, or regulatory issues</span></li></ul><p><span style="font-family:Tahoma, Geneva, sans-serif;font-size:10px;">ABA Standards, Policy, and Provider Support</span></p><ul><li><span style="font-family:Tahoma, Geneva, sans-serif;font-size:10px;">Applies ABA standards of care (including CASP and accreditation-related expectations) and relevant clinical and operational policies during site reviews; translates standards into clear, practical feedback for providers</span></li><li><span style="font-family:Tahoma, Geneva, sans-serif;font-size:10px;">Supports provider advocacy and value-based care goals by assessing treatment models, supervision structures, and utilization patterns with attention to quality, outcomes, and sustainability</span></li><li><span style="font-family:Tahoma, Geneva, sans-serif;font-size:10px;">Maintains working familiarity with ABA industry trends, evolving standards, and payer expectations, incorporating these insights into site visit focus areas and quality improvement recommendations</span></li></ul><p><br><span style="font-family:Tahoma, Geneva, sans-serif;font-size:10px;">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.</span></p><br><br><p><span style="font-family:Tahoma, Geneva, sans-serif;font-size:10px;"><strong>Required Qualifications:</strong></span></p><ul><li><span style="font-family:Tahoma, Geneva, sans-serif;font-size:10px;">Holds active Board Certified Behavior Analyst® (BCBA®) certification in good standing</span></li><li><span style="font-family:Tahoma, Geneva, sans-serif;font-size:10px;">If required by the state of residence- Maintain unrestricted and in good standing licensure and certification</span></li><li><span style="font-family:Tahoma, Geneva, sans-serif;font-size:10px;">Direct experience delivering applied behavior analysis (ABA) services in clinic, home, or community based settings and can independently apply this knowledge during site reviews</span></li><li><span style="font-family:Tahoma, Geneva, sans-serif;font-size:10px;">Brings experience in provider quality oversight, operational review, clinical operations, or similar healthcare support functions involving moderately complex analytical and operational tasks</span></li><li><span style="font-family:Tahoma, Geneva, sans-serif;font-size:10px;">Deep working understanding of Council of Autism Service Providers (CASP) standards of care and can interpret and apply these standards in varied provider environments</span></li><li><span style="font-family:Tahoma, Geneva, sans-serif;font-size:10px;">Familiar with Autism Commission on Quality (ACQ) accreditation standards and able to translate accreditation concepts into practical assessment criteria during provider evaluations</span></li><li><span style="font-family:Tahoma, Geneva, sans-serif;font-size:10px;">Demonstrates the ability to independently integrate data from multiple sources, interpret trends, and synthesize findings into clear, actionable insights</span></li><li><span style="font-family:Tahoma, Geneva, sans-serif;font-size:10px;">Proven ability to communicate clearly in both written and verbal formats and can conduct structured interviews with provider leaders and staff at all levels</span></li><li><span style="font-family:Tahoma, Geneva, sans-serif;font-size:10px;">Proven ability to manage multiple workflows with accuracy, attention to detail, and minimal guidance, including adjusting work in response to variable provider operations</span></li><li><span style="font-family:Tahoma, Geneva, sans-serif;font-size:10px;">Proven capability of interpreting and presenting complex data, trends, and operational metrics in a way that supports decision making and quality improvement</span></li><li><span style="font-family:Tahoma, Geneva, sans-serif;font-size:10px;">Proven solid interpersonal and collaboration skills, with the ability to work effectively with cross functional partners and serve as a resource for colleagues with less experience</span></li><li><span style="font-family:Tahoma, Geneva, sans-serif;font-size:10px;">Ability to travel up to 40%25 to conduct onsite provider reviews and follow up activities</span></li></ul><p><br><span style="font-family:Tahoma, Geneva, sans-serif;font-size:10px;"><strong>Preferred Qualifications:</strong></span></p><ul><li><span style="font-family:Tahoma, Geneva, sans-serif;font-size:10px;">Experience in behavioral health operations, quality oversight, or provider management</span></li><li><span style="font-family:Tahoma, Geneva, sans-serif;font-size:10px;">Experience providing training, creating and/or implementing tools, or processes to improve operational consistency</span></li><li><span style="font-family:Tahoma, Geneva, sans-serif;font-size:10px;">Familiarity with implementing performance improvement frameworks and quality action planning</span></li></ul><p><br><span style="font-family:Tahoma, Geneva, sans-serif;font-size:10px;">*All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy</span></p><p><br><span style="font-family:Tahoma, Geneva, sans-serif;font-size:10px;">Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer 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 us, you’ll find a far-reaching choice of benefits and incentives. The salary for this role will range from $91,700 to $163,700 annually based on full-time employment. We comply with all minimum wage laws as applicable.</span></p><p><br><span style="font-family:Tahoma, Geneva, sans-serif;font-size:10px;"><strong>Application Deadline: </strong>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.</span></p><p style="text-align:center;"><br><span style="font-family:Tahoma, Geneva, sans-serif;font-size:10px;"><i>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.</i></span></p><p style="text-align:center;"> </p><p style="text-align:center;"><br><span style="font-family:Tahoma, Geneva, sans-serif;font-size:10px;"><i>UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.</i></span></p><p style="text-align:center;"><br><span style="font-family:Tahoma, Geneva, sans-serif;font-size:10px;"><i>UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.</i></span></p>

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