This is a fully remote position, open to applicants in Oklahoma, +1 more state.

📋 Description

• Conduct clinical evaluations of therapy services and/or durable medical equipment for members based on service request assessments.

• Offer clinical expertise in alignment with practice standards.

• Collaborate with senior management to explore opportunities for enhancing therapy service reviews and execution.

• Execute utilization assessments of specialty therapy service and/or durable medical equipment requests, adhering to best practices, documentation standards, national therapy association guidelines, and organizational policies.

• Make recommendations for therapy decisions and refer members to care management when necessary.

• Work in tandem with Utilization and Care Management teams, as well as healthcare providers, to ensure suitable care and treatment.

• Broaden therapy specialty knowledge and pinpoint areas for improvement.

• Assist in education, clinical training, consultations, and guidance regarding therapy authorizations and durable medical equipment.

• Provide leadership insights on potential improvements in review processes and therapy service or durable medical equipment outcomes.

• Undertake additional responsibilities as assigned.

• Adhere to all policies and standards.

⛳️ Requirements

• Bachelor’s degree.

• 2–4 years of relevant experience.

• Licensed Occupational Therapist is mandatory.

• PT - Physical Therapist, OT - Occupational Therapist – Registered, or ST - Speech Therapist certification is required.

• Preferred clinical knowledge of therapy services and/or durable medical equipment.

• Familiarity with therapy regulations and guidelines is preferred.

• Understanding of utilization management processes is preferred.

• Work hours may range from as early as 8 AM to as late as 6 PM CST.

• Must be able to support the Texas and Oklahoma markets.

🏝️ Benefits

• Health insurance.

• 401K plan.

• Stock purchase plan.

• Tuition reimbursement.

• Paid time off plus holidays.

• Flexible work options that include remote, hybrid, field, or office schedules.

• Additional forms of incentives may be included in total compensation.