Utilization Manager Physical Therapist

Centene Corp   •  

Omaha, NE

Industry: Healthcare


Less than 5 years

Posted 57 days ago

This job is no longer available.


Position Purpose: Authorize and review utilization of outpatient and home health occupational, physical and speech therapy.

Authorize, direct and monitor care being treated in physical, occupational and speech therapy for medical necessity and appropriateness of care

Review plans of care to ensure functional outcomes and use of clinical practice guidelines

Ensure compliance with performance measures in regards to appeals and denials

Provide support and training to rehabilitation providers, including real

time clinical training, consultation and guidance on matters related to service authorization, provision, and evidence

based practices

Identify areas of concern with regards to deficiencies in the Plan of Care and make appropriate referrals and outreach to assist in improved treatment outcomes

Interact with Medical Director or designee to discuss clinical authorization questions and concerns regarding specific cases


Education/Experience: Master's degree in Speech-Language Pathology, Occupational Therapy, or Physical Therapy. 3+ years of specialty therapy experience in healthcare, home health, or school settings.

License/Certification: Current Certification/Licensure in Speech–Language Pathology, Occupational Therapy, or Physical Therapy in the State of Practice. Speech-Language Pathologists must also possess an active Certificate of Clinical Competence (CCC) from the American Speech-Language-Hearing Association (ASHA).