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Pt Utilization Review Jobs in Iowa (NOW HIRING)

Works collaboratively with physicians, nurses, PT, social workers, family and key caregivers to ... Facilitates patient/family conferences to review treatment goals, optimize resource utilization ...

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Pt Utilization Review information

What is a PT Utilization Review?

Pt Utilization Review jobs involve reviewing patient medical records and treatment plans to ensure that the care provided is medically necessary, appropriate, and in line with insurance policies or regulatory guidelines. Professionals in these roles, often physical therapists or nurses, assess whether ongoing physical therapy services are justified and help facilitate communication between healthcare providers and insurance companies. Their goal is to promote quality patient care while managing healthcare costs and ensuring compliance with regulations.

What are the key skills and qualifications needed to thrive as a PT Utilization Review specialist?

To thrive as a PT Utilization Review Specialist, you need a background in physical therapy (often requiring a DPT degree and state licensure) and strong analytical skills to assess medical necessity and treatment appropriateness. Familiarity with electronic medical records (EMRs), utilization management software, and knowledge of insurance guidelines are typically required. Exceptional communication, critical thinking, and attention to detail help facilitate collaboration with providers and ensure accurate case reviews. These skills are crucial for ensuring patients receive appropriate, evidence-based care while maintaining compliance with regulatory and payer requirements.

What are the typical challenges faced by PT Utilization Review professionals, and how can they be managed?

Physical Therapy Utilization Review professionals often encounter challenges such as balancing clinical judgment with payer guidelines, managing high caseloads, and communicating effectively with both therapists and insurance representatives. Navigating differing opinions about medical necessity and ensuring timely reviews are also common hurdles. Building strong organizational skills, staying updated on insurance policies, and fostering collaborative relationships with clinical teams can help manage these challenges and ensure optimal patient care.

What is the difference between Pt Utilization Review vs Physical Therapist?

AspectPt Utilization ReviewPhysical Therapist
CredentialsTypically requires licensure, certification in utilization review or case managementRequires a Doctor of Physical Therapy (DPT) degree and state licensure
Work EnvironmentHealthcare facilities, insurance companies, case management settingsHospitals, outpatient clinics, rehab centers
Job FocusReviewing medical necessity, approving or denying treatments, ensuring complianceAssessing and treating patients' physical conditions, developing rehab plans

While both roles operate within healthcare, Pt Utilization Review focuses on evaluating treatment necessity and insurance compliance, whereas Physical Therapists provide direct patient care and rehabilitation services.

What job categories do people searching Pt Utilization Review jobs in Iowa look for?

The top searched job categories for Pt Utilization Review jobs in Iowa are:

What cities in Iowa are hiring for Pt Utilization Review jobs?

Cities in Iowa with the most Pt Utilization Review job openings:

Infographic showing various Pt Utilization Review job openings in Iowa as of August 2026, with employment types broken down into 20% Full Time, and 80% Part Time. Highlights an 100% In-person job distribution.

Full-time

Posted 9 days ago


ChenMed rating

8.4

Company rating: 8.4 out of 10

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Job description

We're unique. You should be, too.

We're changing lives every day. For both our patients and our team members. Are you innovative and entrepreneurial minded? Is your work ethic and ambition off the charts? Do you inspire others with your kindness and joy?

We're different than most primary care providers. We're rapidly expanding and we need great people to join our team.

  • The Nurse Practitioner (NP) acts as part of the clinical operations team and is responsible for providing direct patient care in ChenMed/Jencare medical centers, nursing homes, skilled nursing facilities (SNF) and home settings depending on the nature of the assignment or providing assessments to members in SNF and home settings. The responsibilities include but are not limited to: geriatric assessment, medical history, physical exam, diagnosis and treatment, development of the nursing plan of care, health education, physician referrals, case management referrals, follow-up and clear documentation according to ChenMed standards for quality, service, productivity and teamwork. It also includes the participation in clinical rounds and conferences plus in-depth documentation through written progress notes and summaries.
    The Nurse Practitioner must demonstrate the ability to function both independently and in collaboration with other health care professionals. Consults with the manager, physician, and medical director to ensure compliance with guidelines. This position may require participation in risk and quality management programs, clinical meetings and other meetings.
    The Nurse Practitioner will adhere to strict departmental goals/objectives, standards of performance, regulatory compliance, quality patient care compliance, and policies and procedures.
    Functions independently as a certified nurse practitioner for a patient population in collaboration and consultation with a licensed patient care team physician. Practices in accordance with a written or electronic practice agreement.

  • ESSENTIAL JOB DUTIES/RESPONSIBILITIES:

    • Independently assesses acute and non-acute clinical problems. Performs and documents physical assessments and patient histories, analyzes trends in patient conditions, and develops, documents and implements a patient management plan in response to the data obtained. This also includes assisting in the development of the nursing plan of care in addition to providing appropriate patient/ family/significant other counseling and education.

    • Plans patient care based on in-depth knowledge of the specific patient population and/ or protocol, anticipating and identifying physiological and/ or psychological problems commonly encountered including the consideration of the patient's cultural background, level of understanding, personality and support systems. Serves as patient advocate.

    • Patient management includes the following:

    • Writes admission, transfers and discharges orders.

    • Orders and interprets appropriate laboratory and diagnostic studies.

    • Orders of appropriate medication and treatments.

    • Refers patients for consultation when indicated i.e. dermatology, neurology, ophthalmology, endocrine, surgery, intensive care, infectious disease, hematology, psychiatry, social service, dietary, etc.

    • Documentation through in-depth progress notes and summaries.

    • May perform invasive procedures independently upon the completion of documented competency.

    • Participates in patient care rounds and conferences. Communicates patient management strategies to members of the patient care team. Collaborates with members of the multidisciplinary team to ensure that patient management strategies are successful in meeting patient care needs.

    • Recognizes situations which require the immediate attention of a physician, and initiates life-saving procedures when necessary.

    • Uses advanced communication skills to problem solve complex situations and to improve processes and service to patients.

    Other Responsibilities may include:

    • Collaborates with other multidisciplinary team members to analyze and evaluate current systems of health care delivery to identify and implement new practice patterns as appropriate.

    • Participates in outside activities that enhance personal and professional growth and development.

    • Initiates arrangements and writes orders for SNF discharges and completes appropriate paperwork.

    • Works collaboratively with physicians, nurses, PT, social workers, family and key caregivers to transition the patient to a lower level of care as soon as medically appropriate.

    • Introduces self to patient/family and explain nurse practitioner role.

    • Facilitates patient/family conferences to review treatment goals, optimize resource utilization, provide family education and identify post-SNF needs.

    • Enhances a collaborative relationship to maximize the patient's/family's ability to make informed decisions re: goals of care, palliative care and hospice.

    • Facilitates discharge to appropriate level of care and uses preferred providers when additional services are required.

    • Prescribes medication to patients based on State of practice.

    • Other duties as assigned and modified at manager's discretion.

    KNOWLEDGE, SKILLS AND ABILITIES:

    • Demonstrated record of consistently achieving clinical performance metrics in current role

    • Strong Critical Thinking and problem-solving skills

    • Excellent communication and interpersonal skills

    • Time management skills with the ability to work well under pressure

    • Must be caring and empathetic and have great listening skills

    • Must be detail-oriented, and able to pay close attention to patient charts, medications, and follow-up on details of patient care

    • Basic computer skills and some knowledge of Microsoft Office Suite

    • This position may require 50-75% of local travel

    • Flexible to work evening, weekends and/or holidays as needed

    EDUCATION AND EXPERIENCE CRITERIA:

    • ARNP or similar advanced degree in Nursing required

    • Current Nurse Practitioner Certification in the State of practice required

    • Board certification by AANP or ANCC is preferred but may be required for certain States

    • Current DEA number from the DEA for schedule II-V controlled substances may be required based on State of practice

    • Minimum 2 years of clinical experience as a Nurse Practitioner required practicing in Family Medicine, Internal Medicine, or Geriatrics, including past level of autonomy to make independent care decisions

    • Basic Life Support (BLS) certification from the American Heart Association (AMA) or American Red Cross required w/in first 90 days of employment

PAY RANGE:

$111,140 - $158,771 Salary

The posted pay range represents the base hourly rate or base annual full-time salary for this position. Final compensation will depend on a variety of factors including but not limited to experience, education, geographic location, and other relevant factors. This position may also be eligible for a bonuses or commissions.

EMPLOYEE BENEFITS

https://chenmed.makeityoursource.com/helpful-documents

We're ChenMed and we're transforming healthcare for seniors and changing America's healthcare for the better. Family-owned and physician-led, our unique approach allows us to improve the health and well-being of the populations we serve. We're growing rapidly as we seek to rescue more and more seniors from inadequate health care.

ChenMed is changing lives for the people we serve and the people we hire. With great compensation, comprehensive benefits, career development and advancement opportunities and so much more, our employees enjoy great work-life balance and opportunities to grow. Join our team who make a difference in people's lives every single day.

Current employees, if you want to apply to our internal career site, please click HERE

Current Contingent Worker please see job aid HERE to apply

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About ChenMed

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We're expanding healthcare equity across America. We're already in 15 states with 100+ medical centers. As a rapidly growing, physician-led organization, we have one central focus: rescue any and every senior from a healthcare system that has failed them. Our family of brands include Chen Senior Medical Center, JenCare Senior Medical Center, and Dedicated Senior Medical Center. Recently named a 2021 Best Places To Work and one of the only healthcare companies recognized in Fortune's 2020 "Change The World" list, ChenMed prides itself on creating a culture that enables career growth and promotes inclusion for all.

Industry

Health care and social assistance

Company size

5,001 - 10,000 Employees

Headquarters location

Miami, FL, US

Year founded

1985

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