Senior Clinical Review Therapist – Physical Health

This is a fully remote position, open to applicants in Missouri.

📋 Description

• Conduct in-depth clinical evaluations of therapy services and durable medical equipment for members.

• Evaluate and execute utilization reviews for complex requests related to specialty therapy services and durable medical equipment.

• Implement best practices and documentation standards established by national therapy associations and organizational policies.

• Collaborate with Utilization and Care Management teams as well as healthcare providers to ensure suitable member care and treatment.

• Utilize advanced clinical therapy specialty knowledge to pinpoint concerns and areas for improvement.

• Create clinical training programs, consultations, and guidance associated with therapy authorizations and service provisions.

• Work closely with leadership to enhance review processes and outcomes for therapy services or durable medical equipment.

• Provide constructive feedback to leadership regarding opportunities for improvement.

• Carry out additional duties as assigned.

⛳️ Requirements

• Must have authorization to work in the U.S. without requiring employment-based visa sponsorship now or in the future.

• Bachelor's degree is required.

• 4–6 years of relevant experience is necessary.

• PT - Physical Therapist, OT - Occupational Therapist – Registered, or ST - Speech Therapist credentials are mandatory.

• Advanced clinical knowledge of therapy services and/or durable medical equipment is preferred.

• Strong familiarity with therapy regulations and guidelines is preferred.

• Solid knowledge of utilization management processes is preferred.

• Must be available to provide holiday coverage.

• Compliance with all policies and standards is required.

🏝️ Benefits

• Competitive salary.

• Health insurance benefits.

• 401K retirement plan.

• Stock purchase options.

• Tuition reimbursement assistance.

• Paid time off in addition to holidays.

• Flexible work arrangements, including remote, hybrid, field, or office schedules.

• Additional forms of incentives may be included in the overall compensation package.

• Equal opportunity employer dedicated to fostering diversity.