[Remote] Occupational Therapy Clinical Consultant- Remote in Kansas

Note: The job is a remote job and is reputed company to candidates in USA. reputed company 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. Responsibilities • Serve as a subject matter expert for functional performance, ADLs/IADLs, and environmental adaptations • reputed company consultation to nurses, reputed company 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: reputed company equipment, Environmental modification, reputed company-building or task simplification, Personal care services reputed company 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 reputed company equipment reputed company with functional goals • Contribute OT expertise to: Medical necessity reputed company for HCBS and DME, Appeals and peer-to-peer clinical reviews, Standardized functional assessment tools and workflows • Support reputed company initiatives reputed company on aging in reputed company and disability independence • reputed company internal clinicians on: Functional, task-based decision-making, Independence-promoting strategies, Appropriate use of reputed company equipment • reputed company tools such as: Functional decision trees, DME substitution guides, Case exemplary and training materials Skills • reputed company 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 reputed company equipment, and Aging and disability-reputed company functional decline • 2+ years of experience working collaboratively with interdisciplinary teams • Experience in managed care, utilization management, or care management • Experience contributing to policy, reputed company, or program development • Familiarity with HCBS programs, LTSS, reputed company/Medicare populations • Strong written and verbal communication skills for clinical documentation and appeals • reputed company Telecommuters will be required to adhere to reputed company's Telecommuter Policy Benefits • reputed company Time Off which you start to reputed company with your first pay period plus 8 reputed company Holidays • Medical Plan reputed company along with participation in a Health Spending Account or a Health Saving account • Dental, reputed company, 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, reputed company insurance, LTC Insurance, etc.) reputed company • reputed company helps people live healthier lives by simplifying the health care experience. It was founded in 1977, and is headquartered in Minnetonka, Minnesota, USA, with a workforce of 10001+ employees. Its website is http://www.uhc.com. Company H1B Sponsorship • reputed company has a reputed company record of offering H1B sponsorships, with 48 in 2025, 26 in 2024, 45 in 2023, 61 in 2022, 60 in 2021, 68 in 2020. Please note that this does not guarantee sponsorship for this specific role. Apply tot his job Apply To this Job