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Occupational Therapist, Clinical Review – Physical Health
Centene Corporation. Perform clinical reviews of clinical therapy services and/or durable medical equipment for members based on service request assessments .
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in clinical therapy services and durable medical equipment, with a strong focus on utilization management processes and compliance with therapy regulations. Capable of providing clinical leadership and collaborating effectively with care management teams to enhance service outcomes.
Highest-signal resume keywords
Licensed Occupational TherapistUtilization Management ProcessesClinical Therapy ServicesDurable Medical EquipmentKnowledge of Therapy Regulations
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Clinical ReviewsUtilization ReviewsTherapy Service ReviewDocumentation StandardsBest Practices
Soft Skills
CollaborationLeadership FeedbackEducation and Training
Certifications & Qualifications
Licensed Occupational TherapistPT - Physical TherapistOT - Occupational Therapist – RegisteredST - Speech Therapist
Industry Keywords
Therapy ServiceDurable Medical EquipmentClinical KnowledgeNational Therapy Association StandardsCare Management
About the role
Key responsibilities & impact- 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
What you’ll need- 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
Comp & perks- 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