Travel Speech Language Pathologist

4 weeks ago

Bellaire, United States Cynet Health Full time
**Job Title:** Utilization Management Speech Specialist
**Job Specialty:** Speech-Language Pathology
**Job Duration:** 17 Months
**Shift:** Remote, with occasional onsite for special trainings, meetings, or events
**Guaranteed Hours:** 40 Hours Per Week
**Experience:** 2 years of professional speech-language pathology and/or utilization management experience
**License:** Texas Speech-Language Pathology License
**Certifications:** Certificate of Clinical Competence in Speech-Language Pathology (CCC-SLP) through the American Speech-Language-Hearing Association (ASHA)
**Must-Have:**
- Master's Degree in Speech-Language Pathology
- English Proficiency in Speaking, Reading, and Writing
**Job Description:**
- Provide precertification of outpatient and home speech therapy services requiring authorization.
- Conduct telephonic and/or concurrent review of speech therapy services, utilizing clinical judgment and nationally recognized criteria.
- Apply product benefits, understand regulatory requirements, and verify medical necessity.
- Engage in discharge planning and provider education as essential components of the utilization management process.
- Utilize established criteria to certify requested services within the required timeframe.
- Consult with physicians and therapists on patient history and current care needs on an ongoing basis.
- Refer cases that do not meet medical necessity criteria to the medical director or designee for review.
- Perform telephonic preauthorization and concurrent reviews.
- Offer discharge planning options supporting community services and caretaker participation in care coordination.
- Conduct timely entry of information into systems, assign appropriate length of service per guidelines, and communicate authorization numbers to providers and members.
- Evaluate benefit coverage and regulatory guidelines pertinent to decision-making.
**Skills:**
- Knowledge of normal and abnormal development, anatomy, and physiology of the speech/swallowing mechanism.
- Understanding of types of disorders, their etiologies, diagnostic and treatment procedures.
- Ability to diagnose and treat speech, oral motor/swallowing, language, and learning disorders under supervision.
- Proficient in using PC, general office, and audio/video equipment.
- Effective communication skills and ability to retain confidential patient information.
- Excellent verbal, written, and computer skills.
- Experience in managed care organizations or commercial payers, specifically with prior authorizations, is preferred.
- Knowledge of pediatric speech therapy and experience in feeding therapy is a plus.
- Bilingual candidates are encouraged to apply.

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