Utilization Manager - Specialty therapy and Rehabilitative Services

You could be the one who changes everything for our 26 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility.Position Purpose: Authorize and review utilization of outpatient and home health occupational, physical and speech therapy. Authorize, direct and monitor care being treated in physical, occupational and speech therapy for medical necessity and appropriateness of care Review plans of care to ensure functional outcomes and use of clinical practice guidelines Ensure compliance with performance measures in regards to appeals and denials Provide support and training to rehabilitation providers, including real time clinical training, consultation and guidance on matters related to service authorization, provision, and evidence based practices Identify areas of concern with regards to deficiencies in the Plan of Care and make appropriate referrals and outreach to assist in improved treatment outcomes Interact with Medical Director or designee to discuss clinical authorization questions and concerns regarding specific casesEducation/Experience: Master’s degree or equivalent in Speech-Language Pathology, Occupational Therapy, or Physical Therapy. 3+ years of specialty therapy experience in healthcare, home health, or school settings.License/Certification: Current Certification/Licensure in Speech–Language Pathology, Occupational Therapy, or Physical Therapy in the State of Practice. Speech-Language Pathologists must also possess an active Certificate of Clinical Competence (CCC) from the American Speech-Language-Hearing Association (ASHA).Our Comprehensive Benefits Package: Flexible work solutions including remote options, hybrid work schedules and dress flexibility, Competitive pay, Paid time off including holidays, Health insurance coverage for you and your dependents, 401(k) and stock purchase plans, Tuition reimbursement and best-in-class training and development.Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.TITLE: Utilization Manager - Specialty therapy and Rehabilitative ServicesLOCATION: Various, NebraskaREQNUMBER: 1358267