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Clinical Review Ot Jobs (NOW HIRING)

Comagine

Clinical Reviewer (PT or OT-Licensed)

$60K - $81K/yr

Review clinical documentation such as progress notes, images, treatment plans, level of care documents, and other pertinent health care records to determine the medical necessity and/or ...

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Clinical Review Ot information

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$14

$34

$90

How much do clinical review ot jobs pay per hour?

As of Aug 22, 2026, the average hourly pay for clinical review ot in the United States is $34.62, according to ZipRecruiter salary data. Most workers in this role earn between $16.59 and $32.93 per hour, depending on experience, location, and employer.

What is a clinical review OT?

A Clinical Review Occupational Therapist (OT) is a licensed healthcare professional who evaluates medical records and treatment plans to ensure that occupational therapy services are appropriate, effective, and meet clinical guidelines. Clinical Review OTs often work for insurance companies, healthcare organizations, or government agencies, reviewing cases to determine medical necessity and compliance with regulations. They may also provide recommendations for care, support quality improvement initiatives, and help manage healthcare costs. This role generally requires strong analytical skills, clinical experience, and a thorough understanding of current best practices in occupational therapy.

What are the key skills and qualifications needed to thrive as a clinical review OT, and why are they important?

To thrive as a Clinical Review Occupational Therapist, you need a solid background in occupational therapy, clinical assessment skills, and a valid OT license. Familiarity with electronic health record (EHR) systems, medical coding, and utilization review software is typically required. Strong analytical thinking, attention to detail, and effective written communication are essential soft skills for evaluating cases and drafting reports. These skills ensure accurate, evidence-based reviews that support quality patient care and regulatory compliance.

What are some common challenges faced by clinical review OTs when evaluating patient documentation, and how can these be managed?

Clinical Review Occupational Therapists (OTs) often encounter challenges such as incomplete or inconsistent patient records, varying documentation standards across providers, and time constraints for thorough reviews. To manage these, it's important to develop strong communication skills to clarify information with referring clinicians, stay current with documentation guidelines, and utilize checklists or digital tools to streamline the review process. Collaborating with interdisciplinary teams also helps ensure accurate assessments and supports high-quality patient care.

What is the difference between Clinical Review Ot vs Speech-Language Pathologist?

AspectClinical Review OtSpeech-Language Pathologist
CredentialsTypically requires a license in occupational therapy and relevant certificationsRequires a master's degree in speech-language pathology and state licensure
Work EnvironmentHealthcare facilities, insurance companies, telehealthHospitals, clinics, schools, private practice
Industry UsageUsed mainly in healthcare and insurance for case reviewsPrimarily in healthcare, education, and rehabilitation
Job FocusAssessing medical necessity, reviewing treatment plansDiagnosing and treating speech, language, and communication disorders

The main difference between a Clinical Review Ot and a Speech-Language Pathologist is their focus and credentials. Clinical Review Ots primarily evaluate medical necessity and review treatment plans within healthcare and insurance settings, while Speech-Language Pathologists diagnose and treat communication disorders. Both roles require specialized certifications, but their work environments and job functions differ significantly.

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What job categories do people searching Clinical Review Ot jobs look for?

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Clinical Review Ot jobs near you
Infographic showing various Clinical Review Ot job openings in the United States as of August 2026, with employment types broken down into 1% As Needed, 82% Full Time, 13% Part Time, 3% Contract, and 1% Nights. Highlights an 89% Physical, 3% Hybrid, and 8% Remote job distribution, with an average salary of $72,002 per year, or $34.6 per hour.

Senior Clinical Review Nurse - Prior Authorization

Centene Corporation

Remote

$30.58 - $55.09/hr

Other

Medical, Retirement, PTO

Posted 3 days ago

New

Centene rating

8.4

Company rating: 8.4 out of 10

Based on 404 frontline employees who took The Breakroom Quiz

14th of 891 rated healthcare providers

Job description

Clinical Professional

You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility.

This position requires NY State Licensure as a RN, OT or PT

Position Purpose: Routinely reviews more challenging prior authorization requests to determine medical necessity of service and appropriate level of care in accordance with national standards, contractual requirements, and a member's benefit coverage. Assesses more complex authorization requests and provides recommendations to the appropriate medical team to promote quality and cost effectiveness of medical care.

  • Performs medical necessity and clinical reviews of authorization requests to determine medical appropriateness of care in accordance with regulatory guidelines and criteria
  • Collaborates with healthcare providers and authorization team to ensure timely review of services and/or requests to ensure members receive authorized care
  • Escalates prior authorization requests to Medical Directors as appropriate to determine appropriateness of care
  • Manages service authorization requests for a member's transfer or discharge plans to ensure a timely discharge between levels of care and facilities
  • Provides feedback on opportunities to improve the authorization review process for members
  • Manages as appropriate with healthcare providers, utilization management team, and care management team to assess medical necessity of care
  • Partners with interdepartmental teams on projects within utilization management as part of the clinical review team
  • Manages and reviews all member's clinical information in health management systems to ensure compliance with regulatory guidelines
  • Provides education to providers and/or interdepartmental teams on utilization processes to promote high quality and cost-effective medical care to members
  • Develops in-depth knowledge of the prior authorization process and acts as a trainer to other team members
  • Performs other duties as assigned
  • Complies with all policies and standards

Education/Experience: Requires Graduate from an Accredited School of Nursing or Bachelor's degree in Nursing and 4 – 6 years of related experience. Advanced clinical knowledge and ability to analyze authorization requests and determine medical necessity of service preferred. Strong knowledge of Medicare and Medicaid regulations preferred. Strong knowledge of utilization management processes preferred.

  • For Fidelis Plan Only: A clinical degree as a healthcare professional is required along with the appropriate license. Examples include Nursing, PT and OT. required

Pay Range: $30.58 - $55.09 per hour

Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility.

Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.

Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act

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