Job Closed

This listing is no longer active.

Advanced Therapy Services Reviewer

Location

United States

Posted

17 days ago

Salary

0

Seniority

Mid Level

No structured requirement data.

Job Description

Advanced Therapy Services Reviewer

Elevance Health

Role Description The Advanced Therapy Services Reviewer is responsible for conducting timely and quality clinical case evaluations to determine the medical necessity of therapy service requests, ensuring prompt, consistent, and compliant decision-making. Location: Virtual - This role enables associates to work virtually full-time, with the exception of required in-person training sessions (when indicated), providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless accommodation is granted as required by law. How you will make an impact: - Conduct clinical case reviews to assess the medical necessity of therapy services (physical therapy, occupational therapy, and/or speech-language pathology). - Support medical management staff to ensure consistent, timely decisions for members and providers. - Lead peer-to-peer calls with therapist providers to gather clinical information and make determinations. - Render adverse determinations for specific clients when appropriate. - Document findings, develop analyses, and submit reports in compliance with regulatory standards. - Apply company medical policies and guidelines consistently when making decisions. - Escalate cases requiring Medical Director review or policy interpretation. - Participate in departmental projects and initiatives. - Maintain established quality and productivity standards. Qualifications - Requires BA/BS in physical therapy, occupational therapy, or speech language pathology and minimum of 1-year clinical experience; or any combination of education and experience, which would provide an equivalent background. - Current valid, active and unrestricted license as a physical therapist, occupational therapist, or speech language pathologist in applicable state(s) required. Requirements - Master’s degree or higher in physical therapy, occupational therapy, or speech language pathology strongly preferred. Benefits - Market-competitive total rewards including merit increases, paid holidays, and Paid Time Off. - Incentive bonus programs (unless covered by a collective bargaining agreement). - Medical, dental, vision, short and long term disability benefits. - 401(k) + match. - Stock purchase plan. - Life insurance. - Wellness programs and financial education resources.

Related Categories

Related Job Pages

More Therapist Jobs

Expressable logo

Occupational Therapist

Expressable

Committed to improving speech and language outcomes for children and adults with affordable, online therapy.

Therapist17 days ago
Part TimeRemoteTeam 11-50H1B No Sponsor

• Conduct occupational therapy sessions and evaluations for a diverse pediatric population. • Diagnose and develop care plans that address developmental needs, including fine motor, gross motor, sensory processing, and activities of daily living (ADLs). • Educate and empower caregivers on adaptive strategies, home programs, and the use of therapeutic tools to support carryover and long-term outcomes. • Monitor progress, adapt interventions, and ensure safe, effective care in the home environment. • Complete all documentation in accordance with Expressable’s quality and timeliness standards. • Fulfill all required training, licensing/credentialing tasks, and internal communications in a timely manner.

Texas
$40 - $54 / hour

Associate Patient Care Coordinator

UnitedHealth Group

UnitedHealth Group is a healthcare and well-being company that’s dedicated to improving the health outcomes of millions around the world. We are comprised of

Therapist17 days ago

Role Description The Associate Patient Care Coordinator is responsible for scheduling all new patient evaluations, follow-up appointments, answering phones, and mapping routes for home visits. This position is a non-patient facing role. Schedule: Monday-Friday: 8am-5pm CST You’ll enjoy the flexibility to work remotely from anywhere in the U.S. as you take on some tough challenges. Primary Responsibilities: - Provide telephonic patient outreach and patient experience calls - Coordinates patient care as directed by physicians, company standards, and policies - Supports and follows Standard Delegation of Orders (SDO) - Schedules all new patient evaluations for Palliative Care - Schedules all follow-up appointments for Palliative Care Physicians, RN’s, and LVN’s - Responsible for mapping patient home visit driving routes for Palliative providers using a web-based application (Google Maps, Map Quest, etc.) - Building referrals in EMR systems - Updates and maintains master list of Palliative/Bridges Patients for reports - Updates and maintains SharePoint with all patient changes - Answer phones, resolves call or routes to appropriate contact - Manages medical records (maintains, files/scans, prepares for schedule) - Ensures all correspondence is scanned and/or filed in a timely manner - Processes requests for medical records release and maintains appropriate logs, etc. - Ability to work independently - Performs all other related duties as assigned Qualifications - High School Diploma/GED - 2+ years of customer service experience with data entry and strong communication skills both in person and via phone - 1+ years of experience of medical office procedures and medical terminology - 1+ years of experience with navigating Internet tools such as Google Map and Map Quest - Advanced level of proficiency with Microsoft Office applications to include Excel, Word, and Outlook Requirements - Experience in a physician’s office, clinical or hospital setting - Working knowledge of EMR and/or TruCare - Previous experience working in a call center type environment - Bilingual (English/Spanish) language proficiency Benefits - Comprehensive benefits package - Incentive and recognition programs - Equity stock purchase - 401k contribution (all benefits are subject to eligibility requirements)

United States
$16 - $29 / hour
Job Closed
Medtronic logo

Technical Therapy Consultant – Aortic Business

Medtronic

Medtronic is a global leader in medical technology, dedicated to improving healthcare through innovative therapies and devices. Known for transforming patient c

Therapist17 days ago

• Achieve sales revenue and market share targets for a specified region by supporting Aortic (EVAR-TEVAR) cases including sizing & planning report • Provide technical expertise to sales representatives, other sales functions and customers through sales presentations, product demonstrations, installation and maintenance of company products • Support sales & marketing programs with specific complimentary activities as provided by the Marketing team • Ensure the highest level of product knowledge is attained and maintained • Monitor field inventory effectively to ensure appropriate levels of inventory in each location relative to demand • Complete cycle counts of all required field locations on time and follows up on any missing stock • Retrieving all expiring products from field locations and returning to the warehouse prior to expiry • All activities must be performed in compliance with the local Quality System • Perform duties in compliance with environmental, health and safety related site rules, policies, or governmental regulations

Turkey
Job Closed
J.S. Held LLC logo

Certified Life Care Planner

J.S. Held LLC

J.S. Held is a global consulting firm that combines technical, scientific, financial, and strategic expertise to advise clients seeking to realize value and mitigate risk. Our professionals serve as trusted advisors to organizations facing high stakes matters demanding urgent attention, staunch integrity, proven experience, clear-cut analysis, and an understanding of both tangible and intangible assets. The firm provides a comprehensive suite of services, products, and data that enable clients to navigate complex, contentious, and often catastrophic situations.

Therapist17 days ago
Full TimeRemoteTeam 1,001-5,000

Role Description The ideal candidate will bring established client relationships and a proven track record of generating revenue. This role is designed for professionals who can leverage their network to drive immediate impact and accelerate the growth of our practice. In addition to business development, you’ll enjoy high visibility across the organization, opportunities to shape strategy, mentor emerging talent, and contribute to thought leadership initiatives. Job Responsibilities: - Perform technical investigations, analysis, reports and testimony for purposes of litigation matters involving life care plans, including independent medical evaluations. - Perform consulting services for Plaintiff and Defense firms, particularly in the context of personal injury litigation. - Exhibit writing skills through the production of professional, clear, concise, grammatically correct, easily readable, and informative reports. - Capable of taking large and/or medically complex files. - Exhibit exceptional organizational and time management skills, prioritizing assignments to meet deadlines, and ensuring completion of assignments. - Expanded knowledge of medical practices across multiple disciplines. - Exhibit ability to obtain research data to support critical thinking, analyzes case information effectively. - Performs position duties consistently and meets all assignment deadlines. - Works independently and manages time/assignments well. Qualifications - Bachelor’s degree. - 10+ Years of LCP experience. - Entrepreneurial mindset with a passion for building teams, developing services, and growing a business. - Functional in Microsoft Office, Adobe Acrobat, file sharing/email programs, Zoom/Teams. - Works independently with minimal supervision. - Excellent written communication and research skills. - Exhibits critical thinking, meticulous organizational/time management skills. - Highly motivated, self-reliant and can function independently yet collaborative when necessary. Requirements - Practicing RN, MD, or DO (Preferred). - Certified Life Care Planner (CLCP) (Preferred). - Board Certified in Physical Medicine & Rehabilitation (Preferred). - Ability to travel as needed. Benefits - Flexible work environment allows employees to work remotely, when needed. - Flexible Time Off policy. - Medical, Dental, and Vision Insurance. - 401k Match. - Commuter Benefit. - A reasonable estimate of the salary range for this role is $100,000- $175,000.

United States
$100K - $175K / year