THERAPIST REVIEWER, SR
Company: Elevance Health
Location: Topeka
Posted on: October 9, 2024
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Job Description:
Location: This position can be located within 50 miles of our
Pulse Point location in Olathe, KS or Topeka, KSThe Therapist
Reviewer Sr will be responsible for the review of medical records,
including more complex cases, to determine if requests for therapy
services (physical therapy, occupational therapy, and/or
speech-language pathology) are medically necessary and filed
appropriately.How you will make a difference:Applies professional
therapy, government regulation and medical policy knowledge to
medical review, and makes determinations for authorization
requests, meeting all contract requirements, processes and
operational unit goals to ensure customer satisfaction.Maintains
knowledge of regulations and requirements through review of current
regulations and/or policies.Documents findings, develops analyses,
and submits reports to the appropriate departments in accordance
with government regulations and requirements.Researches and obtains
additional data, consults with clinical reviewers and medical
directors, when necessary.Acts as a resource for internal and
external customers.Participates in or leads intradepartmental
teams, projects and initiatives. Maintains quality and productivity
standards, and ensures reviews are conducted within required
timeframes.Minimum Requirements:Requires a graduate of a college
level program in physical therapy, occupational therapy, or speech
language pathology and minimum of 3 years of clinical experience;
or any combination of education and experience, which would provide
an equivalent background.Current active unrestricted license as a
physical therapist, occupational therapist, or speech language
pathologist in applicable state required.Licensure appropriate to
field of specialty as required.Please be advised that Elevance
Health only accepts resumes for compensation from agencies that
have a signed agreement with Elevance Health. Any unsolicited
resumes, including those submitted to hiring managers, are deemed
to be the property of Elevance Health.Who We AreElevance Health is
a health company dedicated to improving lives and communities - and
making healthcare simpler. We are a Fortune 25 company with a
longstanding history in the healthcare industry, looking for
leaders at all levels of the organization who are passionate about
making an impact on our members and the communities we serve.How We
WorkAt Elevance Health, we are creating a culture that is designed
to advance our strategy but will also lead to personal and
professional growth for our associates. Our values and behaviors
are the root of our culture. They are how we achieve our strategy,
power our business outcomes and drive our shared success - for our
consumers, our associates, our communities and our business.We
offer a range of market-competitive total rewards that include
merit increases, paid holidays, Paid Time Off, and 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, to name a few.Elevance
Health operates in a Hybrid Workforce Strategy. Unless specified as
primarily virtual by the hiring manager, associates are required to
work at an Elevance Health location at least once per week, and
potentially several times per week. Specific requirements and
expectations for time onsite will be discussed as part of the
hiring process. Candidates must reside within 50 miles or 1-hour
commute each way of a relevant Elevance Health location.The health
of our associates and communities is a top priority for Elevance
Health. We require all new candidates in certain
patient/member-facing roles to become vaccinated against COVID-19.
If you are not vaccinated, your offer will be rescinded unless you
provide an acceptable explanation. Elevance Health will also follow
all relevant federal, state and local laws.Elevance Health is an
Equal Employment Opportunity employer and all qualified applicants
will receive consideration for employment without regard to age,
citizenship status, color, creed, disability, ethnicity, genetic
information, gender (including gender identity and gender
expression), marital status, national origin, race, religion, sex,
sexual orientation, veteran status or any other status or condition
protected by applicable federal, state, or local laws. Applicants
who require accommodation to participate in the job application
process may contact elevancehealthjobssupport@elevancehealth.com
for assistance.
Keywords: Elevance Health, Overland Park , THERAPIST REVIEWER, SR, Healthcare , Topeka, Kansas
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