Manage Specialty Therapy and Rehabilitation Services (STRS) clinical services including management and marketing of clinical services
Manage clinical services including oversight of clinical policies and procedures and day-to-day operation
Oversee the provider outreach and training activities pre and post implementation
Ensure compliance with established initial and concurrent review, referral, and authorization policies, procedures and processes
Ensure all programs and clinical operations are in full compliance with state and federal regulations, including HIPAA
Ensure payer contract clinical deliverables are met
Monitor the effectiveness of existing procedures and outreach/intervention efforts and ensure full compliance with physical, occupational, speech, and home health scope of practice state guidelines
Analyze data, monitor trends and recommend potential quality improvement opportunities including provider issues, service gaps, member needs
Ensure accurate and timely reporting to health plan partners on authorizations, denials, appeals, provider outreach, call center metrics, and utilization trends to include analytics and interventions
Performs other duties as assigned
Complies with all policies and standards

Master’s degree in Speech, Occupational or Physical Therapy or equivalent
5+ years of specialty therapy or rehabilitation services experience
Thorough knowledge of a specialized or technical field such as case and/or utilization management, including review procedures and educational services
Supervisory experience preferred
Current certification/licensure in Speech-Language Pathology, Occupational Therapy, or Physical Therapy in state of practice

Manager, Specialty Therapy – Rehabilitation Services

Key skills