• Perform audits and quality assurance processes related to claims processing. • Prepare working papers, which record and summarize data in accordance with professional standards. • Organize and maintain audit support files, workpapers, and other relevant documentation. • Analyze healthcare claims data to identify patterns and anomalies. • Prepare detailed reports and dashboards for internal and client use. • Collaborate with cross-functional teams to implement data-driven solutions. • Ensure compliance with healthcare regulations and data privacy standards. • Works as an active team member during scheduled engagements and works collaboratively to achieve the goals of the team. • Provides feedback to the team lead on any issues identified during research or claims review. • Minimal travel may be required based on client needs.

Your Future as a BCBA Starts Here — And It’s Looking Bright Join the largest female clinician-led ABA agency in the country and work with people who just get it. At Autism Learning Partners, we’re all about growing together, learning from each other, and actually making a difference! Whether you're fresh in the field or leveling up, you'll find mentorship, career growth, and a whole community of BCBAs ready to cheer you on. What We’re Offering: - This is a remote role supporting cases in several areas within North Carolina. Travel to your NC regions at least once per quarter for in-person supervision is required. - Base Salary: $82,000 - $90,000 based on experience, skills, and geography - Bonus: Attainable monthly bonus opportunity ($35,000+ in your first three years)! - Initial Onboarding Support: 60+ hours of comprehensive training during the first 3-4 weeks of integration including topics such as clinical best practices, using Central Reach, goal writing, clinical problem solving, CPT codes, telehealth assessments. Our Clinical Development team also offers weekly office hours or 1:1 support, as needed. - Education and Mentorship: Monthly CEUs, annual in-house conference featuring leading researchers in the field, and opportunities to lead sponsored research initiatives - Some Benefits Highlights: 23 days off annually between holidays including 1 floating holiday and 15 days of PTO that begins to accrue from Day 1 - Flexible Schedule: This opportunities to work from home that includes Mon-Fri flexibility in the early and late afternoons up until 6pm some nights, with some evenings until 8pm. No expectation of Saturday work unless you want to schedule make-up sessions. You’re in full control! - Our Promise: We don't require contracts or non-compete agreements because we value flexibility and trust. Your employment with us is fully at-will, allowing you to grow with us on your own terms. Why Choose Us? - A remote role that allows you work/life flexibility while you work from home, only having to be in-person on a semi-monthly basis. - An org chart of nothing but BCBAs between you and the CEO, Dr. Gina Chang, BCBA-D. - A clear path to make values-based clinical decisions based entirely on what is best for your client and family - Generous health insurance package, 401(k) Retirement Program with employer match, and employer paid short-term disability - As a CASP Provider, ALP will grant you access to CASP’s entire CEU library which includes over 75 CEU-approved courses (plus 10 CEUs annually via ALP events such as our IMPACT Conference and monthly live sessions) - Clear promotion framework from BCBA, Sr. BCBA, Assistant Clinical Director, Clinical Director, and Senior Clinical Director - For any new BCBA certificants – we offer the 8-hour supervision course as approved by the BACB - Unlimited referral bonuses - Reasonable expectation of billable hours - Opportunity to partner and/or serve with our internal DEI council - Study support for BCBA candidates and in-house RBT courses to help ensure your team is fully prepared - Support Center resources designed to address your administrative needs, including client intake, recruiting, payroll, HR, billing, credentialing/contracting, and scheduling What You’ll Be Doing: - Lead by Example and Be a Pillar of Support: Inspire and guide Behavior Technicians through effective supervision and support, ensuring that they are implementing treatment plans with a high degree of reliability and fidelity. - Drive Positive Change: Conduct FBAs and develop innovative ABA programs that include continuously evaluating client needs, providing parent education, and problem solving, to help each client reach their potential. - Embrace Challenges with Grace: Stay calm and professional in challenging situations, adapt to change with flexibility, and continuously seek opportunities for growth. - Lead with Initiative and Openness: Proactively communicate, take initiative, and welcome learning to create a safe environment for collaboration and knowledge sharing. What We’re Looking For: - Certification as a Board Certified Behavior Analyst (BCBA) with the Behavior Analyst Certification Board (BACB) - Active LBA Certification in the state of North Carolina as issued by the Board of Registration of Allied Mental Health and Human Services Professions - Please note that this position is subject to a criminal background check, TB test, Pre-employment Physical Exam, and have or receive immunities to MMR/ VZV during our onboarding, which we will pay for Autism Learning Partners supports a diverse workforce and is an Equal Opportunity Employer. At Autism Learning Partners, we understand that culture is the foundation of who we are as a company and how we serve our clients, families, and employees. We are one of the nation's leading full-service ABA providers specializing in the treatment of autism and other developmental disabilities. Our broad thinking approach addresses the whole child by collaborating with doctors, therapists, families, schools, and specialists. Our goal is to work together to achieve the best possible outcome and progress through our commitment to Diversity, Inclusion, and Equity, which includes forming a DEI council, monthly trainings for senior clinical staff, national trainings, a monthly DEI newsletter, continual updates to our email signatures, education on topics like generational trauma and trauma-informed care, and always striving to provide the best care and comfort for our clients, families, and employees. RMTBACR102

This position is National Remote. You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges. Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together. The Benefit Operations Management (BOM) team is responsible for error free point of sale pharmacy script adjudication. The Benefit Operations Management (BOM) team is responsible for error free point of sale pharmacy script adjudication. A Benefit Analyst will play a critical role by partnering with clients and Optum Rx stakeholders to assess, define, and perform pharmacy benefit implementations and ongoing maintenance within the RxCLAIM™ adjudication system. This work includes new plan builds, updates to existing plans, copy/change requests, and global updates. It’s a fast paced, high-volume environment that requires you to work independently while maintaining a strong focus on company policies and guidelines. Accuracy is vitally important and subject to auditing internally and externally to ensure our system is correctly configured and aligned with client defined benefit requirements and performance guarantees. Assets needed for a Benefit Analyst including, but not limited to, a high degree of personal accountability, detail oriented, and can analyze and solve complex problems with excellent conflict resolutions skills. Necessities for this position include timely strong written and verbal skills, superior organizational skills, thinking innovatively, and the ability to work on multiple projects simultaneously and prioritize accordingly. This position is full-time, Monday - Friday. Employees are required to work our normal business hours of 8:00am - 5:00pm local time. It may be necessary, given the business need, to work occasional overtime or weekends. We offer weeks of on-the-job training and the hours during training will be 8:00am to 5:00pm local time, Monday - Friday. Primary Responsibilities: - Analyze benefit requests and secure all necessary data to ensure appropriate implementation based on applied logic of RxCLAIM™ adjudication system - Implement and maintain benefit requirements within the RxCLAIM™ adjudication system according to the client’s intent and within required turnaround time - Utilize system tools and follow documented processes to perform job functions - Work with various cross-functional departments - Perform validation of system benefit configuration and claim testing to ensure accurate adjudication - Perform peer review as assigned - Research and respond to all claims processing inquiries and issues from various cross-functional departments within required turnaround time - Adhere to client performance guarantees, when applicable - Perform quality assurance testing for system enhancements - Assist in the development and roll out of BOM tools and processes - Support projects and business initiative requirements - Subject Matter Expert (SME) in new plan builds, updates to existing plans, copy/change requests, and global updates - Mentor and train team members - Participate in internal and external client meetings to meet demand - Prepare documentation detailing plan features to share with internal and external clients - Perform other duties as assigned You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. Required Qualifications: - High School Diploma / GED or equivalent work experience - Must be 18 years of age OR older - 2+ years of healthcare experience - 1+ years of experience working with RxCLAIM™ adjudication system in a benefit analyst or related position, including ability to navigate the system and understand the functionality at a plan administration level - Advanced level of proficiency in claims processing and issue resolution - Experience with developing processes applicable to the department - Proficiency with Microsoft Word (create and edit correspondence) and Microsoft Excel (ability to create, edit, and sort spreadsheets; apply basic analytical formulas) - Ability to work full-time, Monday - Friday. Employees are required to work our normal business hours of 8:00am - 5:00pm local time. It may be necessary, given the business need, to work occasional overtime or weekends. Preferred Qualifications: - Certified Pharmacy Technician (CPhT) - Retail pharmacy or PBM experience Telecommuting Requirements: - Ability to keep all company sensitive documents secure (if applicable) - Required to have a dedicated work area established that is separated from other living areas and provides information privacy. - Must live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service. Soft Skills: - Engage with client by guiding and leading discussions along with supporting implementations - Experience using critical thinking skills to articulate and inform stakeholders on solutions and issues - Ability to comprehend, analyze data, and calculate results - Ability to problem solve and make educated business decisions - Proven ability to multi-task with attention to detail, remain focused and motivated in a fast paced, collaborative, and changing environment - Excellent interpersonal, organizational, analytical and time management skills as well as the ability to independently manage projects and deadlines - Capability to use tools and technology to perform daily functions - Strong verbal and written communication skills - Ability to work well independently and as a team - Maintain a growth mind set *All employees working remotely will be required to adhere to UnitedHealth 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 comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you’ll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $28.94 - $51.63 per hour based on full-time employment. We comply with all minimum wage laws as applicable. Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants. At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone–of every race, gender, sexuality, age, location, and income–deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups, and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes — an enterprise priority reflected in our mission. UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.

This position is National Remote. You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges. Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together. The Benefit Operations Management (BOM) team is responsible for error free point of sale pharmacy script adjudication. The Benefit Operations Management (BOM) team is responsible for error free point of sale pharmacy script adjudication. A Lead Benefit Analyst will play a critical role by partnering with clients and Optum Rx stakeholders to assess, define, and perform pharmacy benefit implementations and ongoing maintenance within the RxCLAIM™ adjudication system. This work includes new plan builds, updates to existing plans, copy/change requests, and global updates. It’s a fast paced, high-volume environment that requires you to work independently while maintaining a strong focus on company policies and guidelines. Accuracy is vitally important and subject to auditing internally and externally to ensure our system is correctly configured and aligned with client defined benefit requirements and performance guarantees. Assets needed for a Lead Benefit Analyst, including but not limited to, a high degree of personal accountability, detail oriented, and can analyze and solve complex problems with excellent conflict resolutions skills. Necessities for this position include timely strong written and verbal skills, superior organizational skills, thinking innovatively, and the ability to work on multiple projects simultaneously and prioritize accordingly. This position is full-time, Monday - Friday. Employees are required to work our normal business hours of 8:00am - 5:00pm local time. It may be necessary, given the business need, to work occasional overtime or weekends. We offer weeks of on-the-job training and the hours during training will be 8:00am to 5:00pm, Monday – Friday. Primary Responsibilities: - Lead projects and business initiative requirements - Engage with client by guiding and leading discussions along with supporting implementations - Lead the development and roll out of BOM tools and processes - Motivate and lead team participation to drive achievement of goals and objectives - Ability to research, design, recommend, and implement innovative business solutions to complex benefit challenges - Propose solutions for process improvements to leadership - Utilize project leadership skills for complex client implementations and global project initiatives - Analyze benefit requests and secure all necessary data to ensure appropriate implementation based on applied logic of RxCLAIM™ adjudication system - Implement and maintain benefit requirements within the RxCLAIM™ adjudication system according to the client’s intent and within required turnaround time - Utilize system tools and follow documented processes to perform job functions - Work with various cross-functional departments - Perform validation of system benefit configuration and claim testing to ensure accurate adjudication - Perform peer review as assigned - Research and respond to all claims processing inquiries and issues from various cross-functional departments within required turnaround time - Adhere to client performance guarantees, when applicable - Perform quality assurance testing for system enhancements - Subject Matter Expert (SME) in new plan builds, updates to existing plans, copy/change requests, and global updates - Mentor and train team members - Participate in internal and external client meetings to meet demand - Prepare documentation detailing plan features to share with internal and external clients - Perform other duties as assigned You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. Required Qualifications: - High School Diploma / GED OR equivalent work experience - Must be 18 years of age or older - 3+ years of healthcare experience - 2+ years of experience working with RxCLAIM™ adjudication system in a benefit analyst or related position, including ability to navigate the system and understand the functionality at a plan administration level - Experience with developing processes applicable to the department - Advanced level of proficiency in claims processing and issue resolution - Proficiency with Microsoft Word (create and edit correspondence) and Microsoft Excel (ability to create, edit, and sort spreadsheets; apply basic analytical formulas) - Ability to work full-time, Monday - Friday. Employees are required to work our normal business hours of 8:00am - 5:00pm local time. It may be necessary, given the business need, to work occasional overtime or weekends Preferred Qualifications: - Certified Pharmacy Technician (CPhT) - Retail pharmacy or PBM experience Telecommuting Requirements: - Ability to keep all company sensitive documents secure (if applicable) - Required to have a dedicated work area established that is separated from other living areas and provides information privacy - Must live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service Soft Skills: - Ability to work well independently and actively engage a team dynamic - Ability to comprehend, analyze data, and calculate results - Ability to problem solve and make educated business decisions - Strong verbal and written communication skills - Maintain a growth mind set - Proven ability to multi-task with attention to detail, remain focused and motivated in a fast paced, collaborative, and changing environment - Excellent interpersonal, organizational, analytical and time management skills as well as the ability to independently manage projects and deadlines - Capability to use tools and technology to perform daily functions - Experience using critical thinking skills to articulate and inform stakeholders on solutions and issues *All employees working remotely will be required to adhere to UnitedHealth 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 comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you’ll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $35.00 - $62.50 per hour based on full-time employment. We comply with all minimum wage laws as applicable. Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants. At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone–of every race, gender, sexuality, age, location, and income–deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups, and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes — an enterprise priority reflected in our mission. UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.