Responsible for clinically reviewing request for Occupational services in a timely manner utilizing established clinical guidelines and Utilization Management protocols to evaluate for the medical necessity and appropriateness of the requested OT services. Responsible for making organizational determination and escalating cases deemed not medically necessary to the Medical Director. Performs Peer to Peer discussions with requesting providers.
Licensed Occupational Therapist in Florida. Additionally, candidates must be able to apply and successfully obtain their License within 6-12 months from date of hire for the States of GA, NJ and any other State the Company conducts business in.