Therapist Reviewer

Elevance Health • Fort Wayne, IN

4d • Hybrid

About The Position

Therapist Reviewer Location: Fort Wayne IN. This field-based role enables associates to primarily operate in the field, traveling to client sites or designated locations as their role requires, with occasional office attendance for meetings or training. This approach ensures flexibility, responsiveness to client needs, and direct, hands-on engagement. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. The Therapist Reviewer is provides comprehensive support and assistance to the faculty and staff in Fort Wayne, Indiana. This position is specifically dedicated to serve employees, with a hybrid work model both home and in schools. The ideal candidate will be a highly skilled, compassionate professional with a strong background in musculoskeletal health, physical therapy, or sports medicine. This role is pivotal in maintaining the well-being of our employees through preventative care, immediate consultation, and appropriate referrals.

Requirements

• Requires graduate of a college level program in physical therapy or an accredited two year program for a Physical Therapist Assistant, and minimum of 1 year of clinical experience; or any combination of education and experience, which would provide an equivalent background.
• Current active unrestricted license or certification as a physical therapist assistant in applicable state required.
• Certification and/or licensure appropriate to field of specialty as required.

Nice To Haves

• Ability to travel throughout Fort Wayne market preferred.
• Background in orthopedic practice preferred.

Responsibilities

• Applies professional therapy, government regulation, and medical policy knowledge to medical review, and makes determinations for authorization requests, meeting all contract requirements, processes and operational unit goals to ensure customer satisfaction.
• Documents findings, develops analyses, and submits reports to the appropriate departments in accordance with government regulations and requirements.
• Researches and obtains additional data, consults with clinical reviewers and medical directors, when necessary.
• Acts as a resource for internal and external customers.
• May participate in intradepartmental teams, projects, and initiatives.
• Maintains quality and productivity standards and ensures reviews are conducted within required timeframes.

Benefits

• 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.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: Associate degree
• Number of Employees: 5,001-10,000 employees