Clinical Review Therapist, OT, PT, SLP
Centene Corporation
full-time
Posted on:
Location Type: Remote
Location: Texas • United States
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Salary
💰 $31 - $55 per hour
About the role
- Performs 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
- Works with senior management to improve the review and execution of therapy services
- Performs utilization reviews of service requests regarding specialty therapy services and/or durable medical equipment
- Provides recommendations for therapy determinations and refers members to care management
- Collaborates with Utilization and Care Management teams and healthcare providers
- Expands therapy specialty knowledge and identifies areas of improvement for members
- Assists with providing education including developing clinical trainings, consultations, and guidance related to therapy authorizations and/or durable medical equipment
- Provides feedback to leadership on opportunities to improve therapy services outcomes
Requirements
- Requires a Bachelor's degree
- Minimum of 2 – 4 years of related specialty therapy experience (e.g. OT, PT, and SLP)
- Master’s degree in area of specialty therapy and 7+ years of experience preferred
- Clinical knowledge of clinical therapy services, durable medical equipment, and assisted therapy devices preferred
- Experience with Adult and Pediatric Therapy experience preferred
- Advanced clinical knowledge and ability to assess member needs in context of treatment and therapy authorizations
- Knowledge of therapy regulations and guidelines preferred
- Strong attention to detail, organizational and time management skills
- Microsoft Office applications (Co-Pilot, Excel, Outlook, Word, OneNote) proficiency required
- Comfortable using digital video conferencing platforms (Zoom, MS Teams) is required
- Licenses/Certifications: Required OT–Occupational Therapist- Registered required or PT - Physical Therapist required or CCC-SLP - Speech-Language Therapist required and must have an active Certificate of Clinical Competence (CCC) from the American Speech-Language-Hearing Association.
Benefits
- 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
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
clinical therapy servicesdurable medical equipmentutilization reviewstherapy authorizationsadult therapypediatric therapyclinical knowledgeassisted therapy devicestherapy regulationsattention to detail
Soft Skills
organizational skillstime managementcollaborationcommunicationleadershipclinical expertisefeedback provisioneducation development
Certifications
Occupational Therapist RegisteredPhysical TherapistSpeech-Language TherapistCertificate of Clinical Competence