Autism Care Advocate, Remote

About the position

As a Licensed Autism Care Advocate at Optum, you will play a crucial role in improving health outcomes for individuals with Autism by connecting them with the necessary care and resources. This position is primarily telephonic and queue-based, allowing you to work remotely from anywhere in the U.S. You will be responsible for reviewing medical necessity for Applied Behavior Analysis (ABA) requests and providing education and resources to parents and caregivers. The structured schedule for this role is between the business hours of 7 am – 7 pm CST, Monday through Friday, ensuring a balanced work-life dynamic while tackling significant challenges in the field of Autism care. In this role, you will engage directly with healthcare providers to review comprehensive diagnostic evaluations, ensuring that valid diagnoses have been established. You will obtain clinical information regarding ABA treatment requests and determine the medical necessity of additional treatment sessions based on established care guidelines. Your responsibilities will also include managing outpatient cases throughout the entire treatment plan, coordinating benefits, and facilitating transitions between various areas of care, including case management. You will be expected to identify opportunities to enhance treatment plans and consult with facility staff or outpatient care providers to implement these ideas effectively. The pace of work will be fast, and you will be expected to achieve and document measurable results while working with a diverse member population. Your performance will be recognized and rewarded in an environment that encourages professional growth and development, providing clear direction on what it takes to succeed in your role and advance to other positions within the organization.

Responsibilities
• Review comprehensive diagnostic evaluations to ensure valid diagnosis has been given
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• Obtain clinical information from providers on Applied Behavior Analysis requests for treatment
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• Determine if additional clinical treatment sessions for Applied Behavior Analysis are medically necessary in accordance with appropriate level of care guidelines
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• Manage outpatient cases throughout the entire treatment plan
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• Coordinate benefits and transitions between various areas of care including case management
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• Identify ways to add value to treatment plans and consult with facility staff or outpatient care providers on those ideas
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• Provide education and resources to parents/caregivers specific to Applied Behavior Analysis treatment and/or their benefit plan
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• Quote benefits and provide referrals as needed

Requirements
• An active, unrestricted, clinical license that allows you to practice independently (without supervision) in Indiana OR an Indiana-issued BCBA certification
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• 2+ years of post-licensure/certification experience in a related mental health environment
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• Experience working with children and/or adolescents with Autism
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• Computer literacy in a Windows environment including MS Word and Outlook
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• Ability to talk on the phone and type at the same time
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• Access to install secure, high-speed internet at home via cable broadband, DSL or fiber
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• Dedicated, distraction-free workspace at home

Nice-to-haves
• ABA Certification
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• Managed Care experience
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• Utilization Management experience
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• Experience working in an environment that required coordination of benefits and utilization of multiple groups and resources for patients
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• Residency in Indiana

Benefits
• Comprehensive benefits package
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• Incentive and recognition programs
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• Equity stock purchase
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• 401k contribution