Senior Clinical Review Therapist – Physical Health

🔥 0 minutes ago

🏰 Missouri – Remote

🏰 Missouri – Remote

⏰ Full Time

🟠 Senior

😶‍🌫️ 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 complex clinical reviews of clinical therapy services and/or durable medical equipment for members • Assess and perform utilization reviews of complex specialty therapy service and durable medical equipment requests • Apply best-practice and documentation standards from national therapy associations and organizational policies • Collaborate with Utilization and Care Management teams and healthcare providers to ensure appropriate member care and treatment • Apply advanced clinical therapy specialty knowledge to identify concerns and improvement areas • Develop clinical trainings, consultations, and guidance related to therapy authorizations and provisions • Partner with leadership to improve review processes and therapy services or durable medical equipment outcomes • Provide feedback to leadership on improvement opportunities • Perform other duties as assigned

🎯 Requirements

• Must be authorized to work in the U.S. without the need for employment-based visa sponsorship now or in the future • Bachelor's degree • 4–6 years of related experience • PT - Physical Therapist required, or OT - Occupational Therapist – Registered required, or ST - Speech Therapist required • 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 • Must provide holiday coverage • Must comply with all policies and standards

🏖️ Benefits

• Competitive pay • Health insurance • 401K plan • Stock purchase plans • 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 • Equal opportunity employer committed to diversity

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