Remote DPT Clinical Reviewer - Utilization & Care

Socket.dev; United States; On-site; USD 95,000 - 105,000; Full time

Benefits offered by this job

Remote work

Health insurance

401(k) match

Paid parental leave

Pet insurance

Job summary

Cohere Health is seeking a Doctor of Physical Therapy (DPT) to review musculoskeletal and orthopedic cases for medical appropriateness using evidence-based guidelines. This remote role collaborates with medical directors and intake teams to support high-quality decision-making.

You will document determinations clearly, meet turnaround times, and engage in peer-to-peer discussions with treating providers, contributing to improved care access for members.

Qualifications

• DPT from CAPTE-accredited program.
• Active, unrestricted PT license in the state of practice.
• 5+ years of direct clinical patient care experience.
• Familiarity with facilities rendering PT/OT/SLP.
• 1+ years in managed care utilization review (preferred).
• Membership in specialty societies preferred.

Responsibilities

• Provide timely medical reviews meeting Cohere’s quality parameters.
• Provide clinical determinations based on evidence-based criteria.
• Document decisions clearly in Cohere workflow tools for reference.
• Use correct templates for documenting decisions during case review.
• Meet turnaround times for clinical reviews.
• Conduct peer-to-peer discussions with treating providers to clarify information and explain outcomes.
• Support projects to build clinical expertise and efficiency.
• Assist in operational improvements affecting member/provider experience.

Skills

Clinical judgment

Communication

Evidence-based practice

Ambiguity tolerance

Education

CAPTE-accredited DPT program

Job description

Cohere Health is seeking a Doctor of Physical Therapy (DPT) to review musculoskeletal and orthopedic cases for medical appropriateness using evidence-based guidelines. This remote role collaborates with medical directors and intake teams to support high-quality decision-making.

You will document determinations clearly, meet turnaround times, and engage in peer-to-peer discussions with treating providers, contributing to improved care access for members.