Occupational Therapy Clinical Consultant- Remote

Overview

At United Healthcare, we re simplifying the health care experience, creating healthier communities, and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable, and equitable. Ready to make a difference? Join us to start Caring. Connecting. Growing together.

The Occupational Therapy Clinical Consultant provides expert functional assessment and independence-focused clinical guidance to support utilization management, care management, and medical directors in evaluating HCBS, DME, and related services. This role applies occupational therapy principles to promote member independence, ensure appropriate resource utilization, and delay or prevent reliance on personal care services or institutional care.

The role is consultative and non-direct care, enhancing clinical decision-making, consistency, and defensibility across functional determinations. If you are located within the state of Kansas, you will have the flexibility to work remotely as you take on some tough challenges.

• Clinical Consultation & Decision Support
  • 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.
• Functional Assessment & Independence Planning
  • 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
• DME & Assistive Technology Optimization
  • 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.
• Policy, Quality, and Program Development
  • 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.
• Education & Capability Building
  • 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

Put it all together - competitive base pay, a full and comprehensive benefit program, performance rewards, and a management team who demonstrates their commitment to your success. Some of our offerings include:

• 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.)
• More information can be downloaded at: (Use the "Apply for this Job" box below)./uhgbenefits

You ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear directions on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Required Qualifications:

• 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 Qualifications:

• 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 United Health Group s Telecommuter Policy.

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…