Clinical Review Therapist - Physical Health at Centene

You are an Occupational Therapist, Physical Therapist, or Speech-Language Pathologist with at least two to four years of experience. You must hold an active lic

Work type: remote

Salary: $31 – $55/hr

Type: Full-time

Summary

You are an Occupational Therapist, Physical Therapist, or Speech-Language Pathologist with at least two to four years of experience. You must hold an active license issued by the state of Texas, regardless of your current state of residence, and possess a Bachelor’s degree in your field. **What makes it worth a look...** Centene pays between $30.58 and $55.09 per hour for this full-time role. You can work fully remotely from various states while choosing between flexible daily shifts ranging from 6 am to 5 pm. **You might be a good fit if you...** * Have an active OT, PT, or CCC-SLP license issued by Texas. * Possess specific experience with utilization management or medical review processes. * Are proficient in Microsoft Office tools like Excel, OneNote, and Co-Pilot. * Feel comfortable navigating digital video conferencing platforms like Zoom or MS Teams.

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.

Work Schedule: Monday – FridayFlexible Shifts: 6 am - 2 pm, 7 am - 3 pm, 8 am -4 pm, or 9 am - 5 pmNOTE: Candidates may reside in another state, but must have a current OT, PT, or CCC-SLP license issued by the state of TexasPosition 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

Education/Experience: Requires a Bachelor's degree and minimum of 2 – 4 years of related specialty therapy experience (e.g. OT, PT, and SLP).

Preferred Education/Experience:

Master’s degree in area of specialty therapy and 5+ years of experience providing therapy services in-patient, outpatient, home health, and/or managed care settings 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.

Knowledge of utilization management processes preferred.

Role requires adaptability and flexibility to business changes, distribution of work, training, and technology processes

Strong communication, strong attention to detail, organizational and time management skills

Microsoft Office applications (Co-Pilot, Excel, Outlook, Word, OneNote) and the ability to use multiple avenues of digital communication (e.g. instant messaging, email, phone, video conferencing)

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.

NOTE: Candidates may reside in another state, but must have a current OT, PT, or CCC-SLP license issued by the state of Texas

Pay Range: $30.58 - $55.09 per hour

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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