New York Licensed Clinical Peer Reviewer

Job Summary

A company is looking for a Clinical Peer Reviewer (Physical Therapy).

Key Responsibilities

• Review prior authorization and concurrent review cases related to Outpatient Rehab services
• Ensure compliance with regulatory standards and internal turnaround timeframes
• Collaborate with Medical Directors and participate in the development of PT-related clinical policies

Required Qualifications

• Masters of Physical Therapy (MSPT)
• Active, unrestricted NYS PT license
• Minimum 5 years post-residency clinical practice
• Experience in managed care or utilization management
• Knowledge of rehabilitative medicine and PT clinical standards