You could be the one who changes everything for our 28 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.
Work Schedule: Monday – Friday with a flexible/rotating weekend shift, either Saturday or Sunday.
NOTE: Candidates may reside in another state, but must have a current OT, PT, or CCC-SLP license issued by the state of Texas
Position Purpose: Performs clinical reviews of clinical therapy services and/or durable medical equipment to members based on service request assessments and provides clinical expertise based on practice standards. Works with senior management to identify ways to improve the review and execution of therapy services based on clinical reviews of service request assessments.
Education/Experience: Requires a Bachelor's degree and minimum of 2 – 4 years of related specialty therapy experience (e.g. OT, PT, and SLP).
Preferred Education/Experience:
Master’s degree in area of specialty therapy and 5+ years of experience providing therapy services in-patient, outpatient, home health, and/or managed care settings preferred.
Clinical knowledge of clinical therapy services, durable medical equipment, and assisted therapy devices preferred.
Experience with Adult and Pediatric Therapy experience preferred
Advanced clinical knowledge and ability to assess member needs in context of treatment and therapy authorizations
Knowledge of therapy regulations and guidelines preferred.
Knowledge of utilization management processes preferred.
Role requires adaptability and flexibility to business changes, distribution of work, training, and technology processes
Strong communication, strong attention to detail, organizational and time management skills
Microsoft Office applications (Co-Pilot, Excel, Outlook, Word, OneNote) and the ability to use multiple avenues of digital communication (e.g. instant messaging, email, phone, video conferencing)
Comfortable using digital video conferencing platforms (Zoom, MS Teams) is required
Licenses/Certifications: Required
OT–Occupational Therapist- Registered required or
PT - Physical Therapist required or
CCC-SLP - Speech-Language Therapist required and must have an active Certificate of Clinical Competence (CCC) from the American Speech-Language-Hearing Association.
NOTE: Candidates may reside in another state, but must have a current OT, PT, or CCC-SLP license issued by the state of Texas
Pay Range: $30.57 - $55.09 per hour
Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility.
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.
Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act