Clinical Review Therapist - Physical Health at Centene

You're a licensed Physical, Occupational, or Speech Therapist with a Bachelor's degree and 2-4 years of experience, looking to apply your clinical expertise in

Work type: remote

Location: Remote-NY

Salary: $31 – $55/hr

Type: Full-time

Summary

You're a licensed Physical, Occupational, or Speech Therapist with a Bachelor's degree and 2-4 years of experience, looking to apply your clinical expertise in a review capacity. **What makes it worth a look...** Centene is offering a fully remote position with a pay range of $30.58 - $55.09 per hour, focusing on clinical review for therapy services and durable medical equipment. **You might be a good fit if you...** * Hold a NY PT, OT, or ST license. * Are comfortable performing utilization reviews based on national therapy association standards. * Can provide recommendations for therapy determinations and identify areas for service improvement.

Job Description

You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility.
 

Applicants must possess a NY PT or OT LicensePosition Purpose: Performs clinical reviews of clinical therapy services and/or durable medical equipment to members based on service request assessments and provides clinical expertise based on practice standards. Works with senior management to identify ways to improve the review and execution of therapy services based on clinical reviews of service request assessments.

• Performs utilization reviews of service requests regarding specialty therapy services and/or durable medical equipment for members based on best practice and documentation standards by the national therapy associations and organizational policies


• Provides recommendations for therapy determinations and refers members to care management, as appropriate, based on service request assessments


• Works with Utilization and Care Management teams and healthcare providers to ensure members are receiving the appropriate care and treatment


• Expands therapy specialty knowledge and works with senior management to identify areas of improvement with therapy services and/or durable medical equipment 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 the review and therapy services and/or durable medical equipment outcomes to members based on standards and organizational policies


• Performs other duties as assigned


• Complies with all policies and standards

Clinical knowledge of clinical therapy services and/or durable medical equipment preferred.
Knowledge of therapy regulations and guidelines preferred.
Knowledge of utilization management processes preferred.

License/Certification:

• PT - Physical Therapist required or


• OT - Occupational Therapist – Registered required or


• ST - Speech Therapist required

Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules.  Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status.  Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility.

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