UnitedHealthcare · 11 hours ago
Occupational Therapy Clinical Consultant- Remote in Kansas
United States
Full-time
Remote
Senior Level
$28.94/hr - $51.83/hr
5+ years expUnitedHealthcare is simplifying the health care experience and creating healthier communities. The Occupational Therapy Clinical Consultant provides expert clinical guidance to support utilization management and care management, focusing on promoting member independence and ensuring appropriate resource utilization.
FitnessHealth CareWellness
Responsibilities
Serve as a subject matter expert for functional performance, ADLs/IADLs, and environmental adaptations
Provide consultation to nurses, social workers, and medical directors during: HCBS eligibility and level-of-care reviews, Personal care hour determinations and reauthorizations, DME, assistive technology, and home modification requests
Translate functional limitations into appropriate, independence-promoting interventions
Guide clinicians in differentiating: Physical or cognitive impairments vs environmental barriers, Task difficulty vs true dependency, Supervision needs vs hands-on assistance
Recommend stepwise approaches prioritizing: Adaptive equipment, Environmental modification, Skill-building or task simplification, Personal care services when clinically necessary
Review and advise on DME requests for appropriateness, effectiveness, and cost efficiency
Identify alternatives that may reduce or delay reliance on personal care services
Partner with vendor management and policy teams to align equipment options with functional goals
Contribute OT expertise to: Medical necessity criteria for HCBS and DME, Appeals and peer-to-peer clinical reviews, Standardized functional assessment tools and workflows
Support quality initiatives focused on aging in place and disability independence
Educate internal clinicians on: Functional, task-based decision-making, Independence-promoting strategies, Appropriate use of adaptive equipment
Develop tools such as: Functional decision trees, DME substitution guides, Case exemplary and training materials
Qualification
Required
Active Occupational Therapist license (OTR/L) in the state of Kansas
5+ years of clinical OT experience, including: (Home health, community-based care, rehab, or LTSS populations)
2+ years of experience in ADL/IADL assessment, DME and adaptive equipment, and Aging and disability-related functional decline
2+ years of experience working collaboratively with interdisciplinary teams
Preferred
Experience in managed care, utilization management, or care management
Experience contributing to policy, quality, or program development
Familiarity with HCBS programs, LTSS, Medicaid/Medicare populations
Strong written and verbal communication skills for clinical documentation and appeals
All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy
Benefits
Paid Time Off which you start to accrue with your first pay period plus 8 Paid Holidays
Medical Plan options along with participation in a Health Spending Account or a Health Saving account
Dental, Vision, Life& AD&D Insurance along with Short-term disability and Long-Term Disability coverage
401(k) Savings Plan, Employee Stock Purchase Plan
Education Reimbursement
Employee Discounts
Employee Assistance Program
Employee Referral Bonus Program
Voluntary Benefits (pet insurance, legal insurance, LTC Insurance, etc.)
Company
UnitedHealthcare
UnitedHealthcare helps people live healthier lives by simplifying the health care experience.
10001+ employees
H1B Sponsorship
UnitedHealthcare has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (48)
2024 (26)
2023 (45)
2022 (61)
2021 (60)
2020 (68)
Funding
Current Stage
Late StageLeadership Team
Beth Soberg
CEO West Region, Local Markets
Bobby Gregoire
Medicare Health Plan CEO, Iowa & South Dakota
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