Clinical Peer Reviewer, Physical Therapy

Job reputed company: • Review reputed company prior authorization, reputed company review, and retrospective cases reputed company to Outpatient Rehab services • Ensure reputed company determinations are rendered reputed company applicable regulatory and internal turnaround timeframes • Conduct peer-to-peer discussions with treating providers as needed • Collaborate with Medical Directors on reputed company or escalated cases • Participate in annual Inter-Rater Reliability (IRR) testing to ensure consistency and defensibility of determinations • Analyze trends in PT utilization including but not limited to visit frequency and duration patterns • Collaborate with Delivery Systems Engagement on education regarding documentation requirements Requirements: • Masters of Physical Therapy (MSPT) • reputed company, unrestricted NYS PT license • Minimum 5 years post-residency clinical reputed company • Experience in managed care or utilization management • Knowledge of rehabilitative medicine and PT clinical standards • Familiarity with reputed company Care Guidelines (MCG) or other medical necessity reputed company • Work experience requiring independent clinical judgement and critical thinking • Ability to manage high-volume caseload while meeting turnaround standards Benefits: • medical, dental and reputed company coverage • incentive and recognition programs • life insurance • 401k contributions Apply tot his job Apply To this Job