Licensed Clinical Review Speech Therapist (SLP) Utilization Management

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 Utilization Management Speech Therapist primary responsible for review of speech generating device, hearing aid and cochlear implant. The speech therapist will have interaction with the coordinator, medical directors, providers and peers. The speech therapist will also be a consult to other teams regarding speech generating devices.

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
• 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
• Uses pertinent data and facts to identify and solve a range of problems within area of expertise
• Investigates non-standard requests and problems, with some assistance from others
• Works exclusively within a specific knowledge area
• Prioritizes and organizes own work to meet deadlines
• Provides explanations and information to others on topics within area of expertise
• Works under the supervision of a physician. Nurse manager
• Positions are responsible for providing appropriately focused Medical Management Clinical Review of the activities listed below, in support of physician activities, and in accordance with specific review protocols, based on individual member plan documents, national and proprietary coverage review guidelines, and established clinical review guidelines.
• Preservice and Retrospective coverage determinations, and/or
• Appeals for services that have been denied
• Uses technical knowledge and related review protocols in the review of clinical information and documents as they relate to Company medical policy and benefit document language
• Under the direct oversight of physicians or non-physician clinicians, may recommend clinical appropriateness of designated services

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:

• Unrestricted license Speech Therapy in your state of residence
• 3+ years of experience in Speech Therapy working with diverse populations, Special Needs Populations, Pediatrics, and General population adult
• Proficiency in MS Office
• Solid knowledge of practice guidelines, including office procedures, current research and scope of practice
• Proven solid decision-making and administrative skills
• Proven ability to interpret guidelines, research, etc. in the context of traditional Speech Therapy practice
• Proven solid written and verbal communication skills
• Proven ability to be consultative with others including supervisory, clinical and non-clinical professionals

Preferred Qualification:

• Experience in a managed care environment (health plan, medical group, etc.)

Physical & Mental Requirements:

• Ability to push or pull heavy objects using pounds of force
• Ability to properly drive and operate a company vehicle

*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy

California, Colorado, Connecticut, Hawaii, Nevada, New Jersey, New York, Rhode Island, Washington, or Washington, D.C. Residents Only: The hourly range for this role is $33.75 to $66.25 per hour. Pay is based on several factors including but not limited to education, work experience, certifications, etc. 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.