Remote Optum Utilization Review Jobs in Appleton, WI

All Care Therapies is a leading provider of Physical, Occupational, Speech, and ABA therapy services, delivering care through virtual, in-home, and clinic-based settings across California, Texas, and Nevada. We serve individuals of all ages, combining innovative technology with a collaborative, patient-centered approach. Our dedicated clinicians provide flexible, high-quality care that meets patients where they are, supporting recovery, enhancing communication, and driving meaningful, long-term outcomes.

The Board Certified Behavior Analyst (BCBA) is a licensed clinical professional responsible for designing, implementing, supervising, and evaluating Applied Behavior Analysis (ABA) therapy programs for patients across the lifespan. The BCBA at ACT works in alignment with our mission to deliver individualized, compassionate care and maintains clinical excellence in accordance with the BACB's ethical and professional standards.

This role may be performed via tele health, in a clinic environment, in the patient's home, or on-site at a school or care facility — providing maximum flexibility to match the BCBA's preferred work style with ACT's patient population needs.

Clinical Practice

• Conduct comprehensive functional behavior assessments (FBA) and skill assessments (e.g., VB-MAPP, ABLLS-R, PEAK) to identify treatment priorities.
• Develop individualized ABA treatment plans with measurable goals based on assessment findings, patient needs, and family priorities.
• Design, implement, and modify behavior intervention plans (BIPs) using evidence-based ABA methodologies.
• Deliver direct ABA therapy services to patients as clinically indicated and within the scope of the BCBA's practice.
• Monitor patient progress through consistent data collection and analysis; adjust treatment plans accordingly.
• Collaborate with interdisciplinary team members including SLPs, OTs, PTs, physicians, and educators to coordinate holistic care.

Supervision & Team Leadership

• Supervise and mentor Registered Behavior Technicians (RBTs) and BCaBA candidates in accordance with BACB supervision requirements.
• Provide ongoing training, performance feedback, and professional development support to supervisees.
• Conduct regular session observations and ensure fidelity to treatment plans across all service settings.

Documentation & Compliance

• Complete all clinical documentation accurately and within required timeframes, including session notes, progress reports, treatment plans, and authorization requests.
• Maintain compliance with all applicable federal, state, and payer-specific regulations, including HIPAA and Medicaid/insurance billing standards.
• Participate in utilization review and authorization processes in coordination with ACT's billing and operations teams.

Family & Caregiver Collaboration

• Provide caregiver training and coaching to support generalization of ABA strategies across home, school, and community settings.
• Engage families as active partners in treatment planning and progress review.
• Conduct regular parent/caregiver meetings to review goals, data trends, and next steps.

Requirements:

• Active BCBA certification in good standing with the BACB
• Active state licensure where required by the state of practice
• Master's degree in Applied Behavior Analysis, Psychology, Education, or a related field
• Minimum 2 years of ABA clinical experience, including direct therapy and supervision
• Proficiency in ABA assessment tools (FBA, VB-MAPP, ABLLS-R, or equivalent)
• Experience with electronic health records (EHR) and data collection platforms
• Excellent written and verbal communication skills
• Ability to obtain a background clearance per ACT and state requirements

Why Join Us

• We are a therapist-owned and operated organization
• Career Advancement - We believe in recognizing high-performing teams
• Efficient web-based documentation system
• Growing company in a new model of service delivery
• Monthly team meetings
• Supportive collaboration with the Clinical team and Supervisors
• Training, assessments, and materials provided

All your information will be kept confidential according to EEO guidelines.

All Care Therapies is an equal opportunity employer. All aspects of employment, including the decision to hire, promote, discipline, or discharge, will be based on merit, competence, performance, and business needs. We do not discriminate based on race, color, religion, marital status, age, national origin, ancestry, physical or mental disability, medical condition, pregnancy, genetic information, gender, sexual orientation, gender identity or expression, veteran status, or any other status protected under federal, state, or local law.