Primary Duties & Responsibilities

Clinical Oversight:
Confirming attendance of initial evaluation (IE) and receipt of IE Report
Reviews documentation and updates cases with accurate clinical information, including but not limited to ICD codes, Date of Surgery, Clinical Guidelines, ROM/Strength measurements

Obtains, compiles, proofs and processes information received from providers/adjusters to aid in the final determination of a clinical reviewer.
Reviews all assigned cases to provide efficient, cost-effective and quality utilization review services.
Teleservices:
Opens new Telerehab cases in the system and participates in scheduling injured workers for Telerehab
Manages phone calls coming into department through the Telerehab Queue (internal and external calls)
Monitors and handles Telerehab inbox including email, voicemail and fax communications for Teleservices team
Participates in processing continued authorization for Telerehab cases including communication with physician offices and adjusters
Handles other Teleservices duties as assigned

Primary Duties & Responsibilities

Overall Duties:
Documents all pertinent clinical patient/case information and actions into the case notes.
Complies with all established policies and procedures
Assists manager and team in quality improvement projects to provide instructive feedback to practitioners within scope
Attends meetings and trainings.
Meets quality management standards.
Performs activities within the scope of professional licensure.
Completes other duties and projects as assigned.

Qualifications

Must hold a current Philippines Physical Therapy License
Experience: 2-3 years of outpatient hospital clinic setting strongly preferred
Knowledgeable of current physical medicine treatments
Excellent verbal and written communication skills
Organizational skills, prioritization, problem-solving and decision making skills are required
Ability to multi-task in a fast paced environment
Must be computer literate and be able to use the keyboard accurately. Experience with Microsoft Office and Zoom app are desired.
Strong analytical and interpersonal skills are also required.
Not required, but desired: current US Physical Therapy license and/or Doctor of Physical Therapy degree
Experience in utilization review, case management, quality improvement and/or managed care is desired

Clinical Analyst Level I