Occupational Therapist, Clinical Review – Physical Health

🔥 12 minutes ago

🌪️ Oklahoma, Texas – Remote

🌪️ Oklahoma – Remote 🤠 Texas – Remote

💵 $30 - $55 / hour

⏰ Full Time

🟢 Junior

🟡 Mid-level

😶‍🌫️ Therapist

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Centene Corporation

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1984

🛡️ Insurance

💼 Consulting

🏥 Healthcare

Insurance • Consulting • Healthcare

Centene Corporation is a leading provider of government-sponsored healthcare services, specializing in delivering affordable and high-quality healthcare solutions. For over 40 years, Centene has focused on transforming the health of communities by expanding access to Medicaid, Medicare, and Health Insurance Marketplace services, as well as serving military communities through the TRICARE program. As the largest Medicaid managed care organization and a key participant in the Marketplace, Centene emphasizes localized healthcare delivery combined with strong partnerships with nonprofit organizations to meet the unique needs of its members. Centene is also committed to corporate sustainability and social responsibility, prioritizing environmental stewardship and ethical governance to enhance the well-being of the communities it serves.

📋 Description

• Perform clinical reviews of clinical therapy services and/or durable medical equipment for members based on service request assessments • Provide clinical expertise based on practice standards • Work with senior management to identify ways to improve therapy service review and execution • Perform utilization reviews of specialty therapy service and/or durable medical equipment requests using best practices, documentation standards, national therapy association standards, and organizational policies • Provide recommendations for therapy determinations and refer members to care management as appropriate • Collaborate with Utilization and Care Management teams and healthcare providers to ensure appropriate care and treatment • Expand therapy specialty knowledge and identify improvement opportunities • Assist with education, clinical trainings, consultations, and guidance related to therapy authorizations and durable medical equipment • Provide leadership feedback on opportunities to improve review and therapy service or durable medical equipment outcomes • Perform other duties as assigned • Comply with all policies and standards

🎯 Requirements

• Bachelor's degree • 2–4 years of related experience • Licensed Occupational Therapist required • PT - Physical Therapist required, or OT - Occupational Therapist – Registered required, or ST - Speech Therapist required • 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 • Hours may be as early as 8am and as late as 6pm CST • Must support the Texas and Oklahoma markets

🏖️ Benefits

• Health insurance • 401K plan • Stock purchase plan • Tuition reimbursement • Paid time off plus holidays • Flexible approach to work with remote, hybrid, field or office work schedules • Additional forms of incentives may be included in total compensation

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