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The Role

The Physical Therapy Utilization Management Reviewer is responsible for evaluating the appropriateness and medical necessity of outpatient rehabilitation services. The position works to ensure services align with established clinical guidelines and policies. This position is part of a larger team and works independently and collaboratively to facilitate care using clinical skills, principles of managed care, nationally recognized medical necessity criteria, and company medical policies to conduct reviews that promote efficient and medically appropriate use of the member’s benefit to provide the best quality care.


The Team

The Physical Therapy Utilization Management Reviewer is part of a highly dedicated and motivated team of professionals. The team includes clinicians, medical and behavioral health care managers, dietitians, pharmacists, medical directors and more, who ...