Senior Clinical Review Therapist - Physical Health
December 4
Description
• Performs complex clinical reviews of clinical therapy services and/or durable medical equipment to members based on service request assessments • Provides clinical expertise based on practice standards • Applies clinical knowledge and provides recommendations to senior management • Assesses and performs utilization reviews of service requests regarding complex specialty therapy services • Manages and collaborates with Utilization and Care Management team and healthcare providers • Applies advanced clinical therapy specialty knowledge • Provides education including developing clinical trainings, consultations, and guidance related to therapy authorizations and provisions • Partners with leadership on opportunities to improve review outcomes • Provides feedback on review opportunities • Complies with all policies and standards
Requirements
• Requires a Bachelor's degree • 4 – 6 years of related experience • Advanced clinical knowledge of clinical therapy services and/or durable medical equipment preferred • Strong knowledge of therapy regulations and guidelines preferred • Strong knowledge of utilization management processes preferred • PT - Physical Therapist required or OT - Occupational Therapist – Registered required or ST - Speech Therapist required
Benefits
• competitive pay • health insurance • 401K and stock purchase plans • tuition reimbursement • paid time off plus holidays • flexible approach to work with remote, hybrid, field or office work schedules
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