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Pt Utilization Review Jobs in Nebraska (NOW HIRING)

... utilization review for the purpose of clinical reimbursement. The MDS Coordinator confers with ... These benefits are available to full-time employees. 401k is available to FT and PT employees.

... Standards, GPS-PT 6, and serve as the site's primary subject matter expert for contractor ... Drive continuous improvement across contractor management, SAP utilization, and cost control ...

... Standards, GPS-PT 6, and serve as the site's primary subject matter expert for contractor ... Drive continuous improvement across contractor management, SAP utilization, and cost control ...

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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 Nebraska look for?

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

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

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

Infographic showing various Pt Utilization Review job openings in Nebraska as of August 2026, with employment types broken down into 1% As Needed, 80% Full Time, 15% Part Time, 3% Contract, and 1% Nights. Highlights an 87% Physical, 4% Hybrid, and 9% Remote job distribution.

$35/hr

Other

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 18 days ago


Job description

Accura HealthCare of Pierce has the opportunity to welcome a MDS Coordinator (RN) to join our team! Our MDS Coordinators are passionate about assessing the needs of our residents to provide the support and care they need and promote the physical, mental, emotional, and spiritual well-being of our residents and team members. If this sounds like the ideal culture you desire, we welcome the opportunity to work with you!
JOB HIGHLIGHTS:
  • Starting pay $35.00/hr., increases depending on experience (DOE)
  • Supportive regional operational and clinical support
  • Full-time benefits 32+ hours
  • Every 3rd weekend required
  • Participate in on-call rotation
  • Strong & supportive Leadership Team
ABOUT OUR COMMUNITY:
Accura HealthCare of Pierce is a Skilled Nursing Facility (SNF) located in Pierce, NE. We embrace a unique, upside-down philosophy that places residents, patients, and direct care employees at the very top of the organizational chart. That includes you! We take pride in providing quality, person-centered care, in addition to fostering an environment that team members want to be a part of. If you desire an organization that creates an environment that allows both our residents and team members to thrive, consider Accura HealthCare and join us in being partners in care, family for life.
ABOUT ACCURA HEALTHCARE: Accura HealthCare is a Midwest-based healthcare company that manages and operates over 50 skilled nursing care, assisted living, independent living, and memory care communities throughout Iowa, Minnesota, South Dakota, and Nebraska. From its beginning in 2016 with 9 care communities, Accura HealthCare has held true to its mission and vision while serving others. Built on the pillars of trust, integrity, accountability, commitment, and kindness, Accura HealthCare is a leader in the Midwest in providing high-quality care. Our employees play a key role in supporting our purpose, "to care for others," while advancing our mission "to be partners in care, family for life."
OUR BRANDS: Accura HealthCare | Stonebridge Suites | Traditions Memory Care
OUR VALUES: Trust. Integrity. Accountability. Commitment. Kindness.
  • Accura HealthCare is where personal life and work life blend together to bring value and purpose to one's existence
JOB SUMMARY:
The MDS (Minimum Data Set) Coordinator is required to be knowledgeable of applicable laws and/or licensing regulations for healthcare facilities. This includes compiling information, preparing statistical reports and data from health records, and personalized assessments for use in the evaluation of quality of care and utilization review for the purpose of clinical reimbursement. The MDS Coordinator confers with physicians, nurses, and other health personnel to ensure complete, current, and accurate medical records.
QUALIFICATIONS:
  • Current licensure as a Registered Nurse (RN) in the applicable state, without restrictions, and/or ability to obtain state-specific license
  • MDS experience required
  • Strong attention to details and deadlines
  • Analytical skills required
  • Must be capable of performing the Essential Functions of this job, with or without reasonable accommodation
BENEFITS:
  • Vacation time, Sick time & Paid Holidays*
  • Medical, Dental, & Vision Benefits*
  • Flexible Spending Account*
  • Employer Paid Life & AD&D*
  • Supplemental Benefits*
  • Employee Assistance Program
  • 401(k) with company match
  • Education Assistance available through education partners

*These benefits are available to full-time employees. 401k is available to FT and PT employees. Minnesota and Nebraska employees are eligible for Sick time regardless of status.
Accura HealthCare, an Equal Opportunity Employer and leading post-acute healthcare provider based in Iowa, has communities in Iowa, Minnesota, South Dakota, and Nebraska, and growing!