Job Description
Job Description
This role is open to Telework anywhere!
Standard business hours - M-F, no weekends or holidays!
-Utilizes physical therapy/rehabilitative clinical experience and skills in a collaborative process to review episodes of care to administer appropriate coverage decisions/benefits for members.
-Gathers clinical information and applies the appropriate clinical criteria/guideline, policy, procedure and clinical judgment to render coverage determinations or recommendation.
-Communicates coverage determinations to providers and members Identifies opportunities to promote quality effectiveness of healthcare services and benefit utilization. -Consults and lends expertise to other internal and external constituents in the coordination and administration of benefits coverage.
-Typical Office working environment with productivity and quality expectations
-Review requires navigation through multiple system
applications as well as potential requirement to outreach to internal department or providers.
-Adhere to company policies regarding confidentiality to
protect member information.
Required Qualifications
-Physical Therapist Licensure
-Minimum 3-5 years required
-Position requires proficiency with computer skills which includes navigating multiple systems and keyboarding
Effective communication skills, both verbal and written
Preferred Qualifications
-Work requires the ability to perform close inspection of hand written and computer generated documents as well as PC monitor
-Ability to work with people in such a manner as to build high
morale and group commitment to goals and objectives
Education
-Physical Therapy Degree & Licensure allowing independent practice
Business Overview
At Aetna, a CVS Health company, we are joined in a common purpose: helping people on their path to better health. We are working to transform health care through innovations that make quality care more accessible, easier to use, less expensive and patient-focused. Working together and organizing around the individual, we are pioneering a new approach to total health that puts people at the heart.
This role is open to Telework anywhere!
Standard business hours - M-F, no weekends or holidays!
-Utilizes physical therapy/rehabilitative clinical experience and skills in a collaborative process to review episodes of care to administer appropriate coverage decisions/benefits for members.
-Gathers clinical information and applies the appropriate clinical criteria/guideline, policy, procedure and clinical judgment to render coverage determinations or recommendation.
-Communicates coverage determinations to providers and members Identifies opportunities to promote quality effectiveness of healthcare services and benefit utilization. -Consults and lends expertise to other internal and external constituents in the coordination and administration of benefits coverage.
-Typical Office working environment with productivity and quality expectations
-Review requires navigation through multiple system
applications as well as potential requirement to outreach to internal department or providers.
-Adhere to company policies regarding confidentiality to
protect member information.
Required Qualifications
-Physical Therapist Licensure
-Minimum 3-5 years required
-Position requires proficiency with computer skills which includes navigating multiple systems and keyboarding
Effective communication skills, both verbal and written
Preferred Qualifications
-Work requires the ability to perform close inspection of hand written and computer generated documents as well as PC monitor
-Ability to work with people in such a manner as to build high
morale and group commitment to goals and objectives
Education
-Physical Therapy Degree & Licensure allowing independent practice
Business Overview
At Aetna, a CVS Health company, we are joined in a common purpose: helping people on their path to better health. We are working to transform health care through innovations that make quality care more accessible, easier to use, less expensive and patient-focused. Working together and organizing around the individual, we are pioneering a new approach to total health that puts people at the heart.
We are committed to maintaining a diverse and inclusive workplace. CVS Health is an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring or promotion based on race, ethnicity, gender, gender identity, age, disability or protected veteran status. We proudly support and encourage people with military experience (active, veterans, reservists and National Guard) as well as military spouses to apply for CVS Health job opportunities.
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