Clinical Review Therapist - Physical Health

This role involves performing clinical reviews of therapy services and durable medical equipment for members, providing clinical expertise, and collaborating with healthcare teams to ensure appropriate care. It is suitable for licensed therapy professionals with experience in specialty therapy.

Location: Texas (Statewide Candidates considered, license required)

Salary: $30.58–$55.09 per hour

Responsibilities

• Performs utilization reviews of service requests regarding specialty therapy services and/or durable medical equipment for members based on best practice and documentation standards.
• 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.

Requirements

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

Benefits

• Competitive pay
• Health insurance
• 401K and stock purchase plans
• Tuition reimbursement
• Paid time off plus holidays
• Flexible work arrangements including remote, hybrid, field, or office schedules.

Additional Information

• Must have a current OT, PT, or CCC-SLP license issued by the state of Texas.
• Role requires adaptability and flexibility to business changes, distribution of work, training, and technology processes.
• Strong communication, attention to detail, organizational and time management skills.
• Proficiency in Microsoft Office applications and digital communication platforms.
• Comfortable using digital video conferencing platforms.