Speech Language Pathology Therapist Reviewer Senior

5 days ago

Olathe, Kansas, United States Elevance Health Full time
Job Summary

We are seeking a highly skilled Speech Language Pathology Therapist Reviewer Senior to join our team at Elevance Health. As a key member of our medical review team, you will be responsible for reviewing medical records, including complex cases, to determine if requests for therapy services are medically necessary and filed appropriately.

Key Responsibilities
  • Apply professional therapy, government regulation, and medical policy knowledge to medical review, making determinations for authorization requests, meeting all contract requirements, processes, and operational unit goals to ensure customer satisfaction.
  • Maintain knowledge of regulations and requirements through review of current regulations and/or policies.
  • Document findings, develop analyses, and submit reports to the appropriate departments in accordance with government regulations and requirements.
  • Research and obtain additional data, consult with clinical reviewers and medical directors, when necessary.
  • Act as a resource for internal and external customers.
  • Participate in or lead intradepartmental teams, projects, and initiatives. Maintain quality and productivity standards, and ensure reviews are conducted within required timeframes.
Requirements
  • Requires a graduate of a college level program in speech language pathology and minimum of 3 years of clinical experience; or any combination of education and experience, which would provide an equivalent background.
  • Current active unrestricted license as a speech language pathologist in applicable state required.
  • Licensure appropriate to field of specialty as required.
About Elevance Health

Elevance Health is a health company dedicated to improving lives and communities – and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.

We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs, and financial education resources, to name a few.

Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process. Candidates must reside within 50 miles or 1-hour commute each way of a relevant Elevance Health location.

The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state, and local laws.

Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status, or any other status or condition protected by applicable federal, state, or local laws.

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