Senior Clinical Review Therapist - Physical Health

Centene Corporation; Minnesota; Remote; USD 60,000 - 80,000; Full time

Job summary

Centene Corporation seeks a Senior Clinical Review Therapist to perform clinical reviews and provide expertise on therapy services to enhance member care. This remote position requires strong clinical knowledge, collaboration with management, and involves education and training within healthcare settings.

Benefits

Comprehensive benefits package

Competitive pay

401K and stock purchase plans

Tuition reimbursement

Flexible work schedules

Qualifications

• 4 – 6 years of related experience required.
• Advanced clinical knowledge of clinical therapy services preferred.
• Strong knowledge of therapy regulations and guidelines preferred.

Responsibilities

• Perform complex clinical reviews of therapy services.
• Collaborate with Utilization and Care Management team.
• Provide education and develop clinical trainings.

Skills

Clinical therapy services

Utilization management processes

Therapy regulations and guidelines

Education

Bachelor's degree

Job description

Senior Clinical Review Therapist - Physical Health

3 days ago Be among the first 25 applicants

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.

• POSITION IS REMOTE***
  
  

Position Purpose Performs complex 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. Applies clinical knowledge and provides recommendations to senior management team to identify ways to improve the review and execution of therapy services based on clinical reviews of service request.

• Assesses and performs utilization reviews of service requests regarding complex 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
• Manages and collaborates works with Utilization and Care Management team and healthcare providers to ensure members are receiving the appropriate care and treatment
• Applies advanced clinical therapy specialty knowledge and identifies areas of concern and improvement with therapy services and/or durable medical equipment for members
• Provides education including developing clinical trainings, consultations, and guidance related to therapy authorizations and provisions
• Partners with leadership on opportunities to improve the review and therapy services and/or durable medical equipment outcomes to members based on standards and organizational policies
• 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 4 – 6 years of related experience.

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

Strong knowledge of therapy regulations and guidelines preferred.

Strong knowledge of utilization management processes preferred.

License/Certification

• PT - Physical Therapist required or
• OT - Occupational Therapist – Registered required or
• ST - Speech Therapist required
  
  

Pay Range $35.49 - $63.79 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.

Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.

Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act

Seniority level

• Seniority level

  Not Applicable

Employment type

• Employment type

  Full-time

Job function

• Job function

  Health Care Provider

• Industries

  Hospitals and Health Care and Insurance

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