Texas Licensed Clinical Review Therapist

Job Summary

To support a growing Medical Management/Health Services team, the full-time Texas Licensed Clinical Review Therapist will perform clinical reviews of therapy services and durable medical equipment requests, collaborating with management and healthcare providers to ensure appropriate member care, all while working remotely.

Key responsibilities

• Conduct utilization reviews of service requests for specialty therapy services and durable medical equipment based on best practices and documentation standards
• Provide recommendations for therapy determinations and refer members to care management as needed
• Assist in developing clinical trainings and provide feedback to leadership on improving therapy services and outcomes

Required qualifications

• Bachelor's degree with 2-4 years of related specialty therapy experience (OT, PT, SLP)
• Current Texas OT, PT, or CCC-SLP license at the time of application submission
• Clinical knowledge of therapy services and durable medical equipment
• Experience with adult and pediatric therapy preferred
• Knowledge of therapy regulations and utilization management processes preferred