Occupational Therapy Clinical Consultant- Remote in Kansas

At UnitedHealthcare, 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.

Primary Responsibilities:

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

What are the reasons to consider working for UnitedHealth Group?   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: http://uhg.hr/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.