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Texas Licensed Therapist

Eingestellt von Dynamic Computing Services Corporation

Gesuchte Skills: Network, Client, Support

Projektbeschreibung

Our client has an opening for Texas Licensed Therapist to support a contract role in Austin, TX.

REQUIREMENTS:

- Must meet Texas State licensure requirements for practicing in related field(s) and possess current and unrestricted PT, OT, or ST license from the State of Texas.
- Minimum of two (2) years post licensure experience in area of licensure in a hospital, clinic or agency.
- Basic computer knowledge with the ability to learn additional computer programs, required.
- Demonstrated ability to effectively and sensitively interact with people from different cultural groups.
- Prior Authorization experience.
- Knowledge of utilization management process and ability to interpret and apply member contracts, and member benefits, preferred.
- Bachelor's degree (or higher) in Physical, Occupational, Speech Therapy from an approved/accredited school in related field (APTA, NBCOT, ASHA).

RESPONSIBILITIES:

- Collaborates with healthcare providers and members to promote quality member outcomes, to optimize member benefits, and to promote effective use of resources.
- Ensures medically appropriate, high quality, cost effective care through assessing the medical necessity of prescribed development or rehabilitative and out of network services, and appropriateness of treatment setting within the scope of professional limitations by utilizing the applicable rules of the Texas Administrative Code (TAC), Texas Health and Human Services Commission (HHSC) approved medical policy, and industry standards.
- Accurately interprets benefits and managed care products, and may steer members to appropriate providers, programs or community resources.
- Works with medical directors in interpreting appropriateness of care.
- Conducts pre-service, concurrent/continued stay, retrospective, out of network and appropriateness of treatment setting reviews to ensure compliance with applicable criteria, medical policy, and member eligibility, benefits, and contracts.
- Conducts review activities which require the review of clinical information against client specific criteria, but excludes denial determinations.
- Ensures member access to medical necessary, quality healthcare in a cost effective setting according to contract.
- Consults with clinical reviewers and/or medical directors regarding member's diagnosis, strengths and deficits, current functioning at home, at work and in the community to ensure medically appropriate, high quality, cost effective care throughout the medical management process.
- Collaborates with providers to assess members, needs for early identification of and proactive planning for therapy.
- Facilitates accreditation by knowing, understanding, correctly interpreting, and accurately applying accrediting and regulatory requirements and standards.

Projektdetails

  • Einsatzort:

    Austin, Vereinigte Staaten

  • Projektbeginn:

    asap

  • Projektdauer:

    Initial 3 months

  • Vertragsart:

    Contract

  • Berufserfahrung:

    Keine Angabe

Geforderte Qualifikationen

Dynamic Computing Services Corporation