... utilization. The NAD is expected to interact routinely and collaboratively with multiple ... Conducts Quarterly Business Reviews * Proficiency with sales support technology - example ...
... utilization. The NAD is expected to interact routinely and collaboratively with multiple ... Conducts Quarterly Business Reviews * Proficiency with sales support technology - example ...
Speech Language Pathologist
Alpharetta, GA · Remote
$40 - $45/hr
About This Role The Remote Speech-Language Pathologist (SLP) provides comprehensive speech and ... Collaborate with BCBAs, Occupational Therapists, physicians, psychologists, educators, and other ...
Quick apply
Speech Language Pathologist
Alpharetta, GA · Remote
$40 - $45/hr
About This Role The Remote Speech-Language Pathologist (SLP) provides comprehensive speech and ... Collaborate with BCBAs, Occupational Therapists, physicians, psychologists, educators, and other ...
Patient Access Representative
Atlanta, GA · Remote
$19 - $20/hr
Schedule * Full Time: Mon-Fri (10am-7pm ET) * 100% remote position supporting our Wellstar ... therapy, occupational therapy, speech-language pathology, and athletic training. As we aim to be ...
Patient Access Representative
Atlanta, GA · Remote
$19 - $20/hr
Schedule * Full Time: Mon-Fri (10am-7pm ET) * 100% remote position supporting our Wellstar ... therapy, occupational therapy, speech-language pathology, and athletic training. As we aim to be ...
Acquisition Utilization Specialist
Smyrna, GA · On-site +1
$74K - $123K/yr
Coordinates and reviews vendor evaluations, monitors contract expenditures, and reports on ... Remote: This position is not authorized for Remote work. Telework: This position may be authorized ...
Acquisition Utilization Specialist
Smyrna, GA · On-site +1
$74K - $123K/yr
Coordinates and reviews vendor evaluations, monitors contract expenditures, and reports on ... Remote: This position is not authorized for Remote work. Telework: This position may be authorized ...
Speech Language Pathologist (SLP) Remote
Atlanta, GA · Remote
$45 - $52/hr
Company Description All Care Therapies is a leading provider of Physical, Occupational, Speech, and ... Provide remote speech-language therapy services to clients * Conduct online speech-language ...
Quick apply
Speech Language Pathologist (SLP) Remote
Atlanta, GA · Remote
$45 - $52/hr
Company Description All Care Therapies is a leading provider of Physical, Occupational, Speech, and ... Provide remote speech-language therapy services to clients * Conduct online speech-language ...
This is a remote role with travel, focused on supporting clients in the Greater Atlanta area and ... Bachelor's degree in health sciences, Occupational Therapy or Physical Therapy * 1-3 years of ...
Quick apply
This is a remote role with travel, focused on supporting clients in the Greater Atlanta area and ... Bachelor's degree in health sciences, Occupational Therapy or Physical Therapy * 1-3 years of ...
Assistive Technology Professional (ATP) - Georgia
Atlanta, GA · On-site +1
$80K - $100K/yr
This is a remote role with travel, focused on supporting clients in the Greater Atlanta area and ... Bachelor's degree in health sciences, Occupational Therapy or Physical Therapy * 1-3 years of ...
Assistive Technology Professional (ATP) - Georgia
Atlanta, GA · On-site +1
$80K - $100K/yr
This is a remote role with travel, focused on supporting clients in the Greater Atlanta area and ... Bachelor's degree in health sciences, Occupational Therapy or Physical Therapy * 1-3 years of ...
Physical Therapist Pediatric Telehealth
Atlanta, GA · Remote
$50 - $60/hr
... remote pediatric Physical Therapy services to clients ages 0-21. This is a W-2 position with ... Communicating with families to review progress, support carryover, and establish home exercise/home ...
Quick apply
Physical Therapist Pediatric Telehealth
Atlanta, GA · Remote
$50 - $60/hr
... remote pediatric Physical Therapy services to clients ages 0-21. This is a W-2 position with ... Communicating with families to review progress, support carryover, and establish home exercise/home ...
Case Manager
Alpharetta, GA · Remote
$19.50 - $25.25/hr
Information Technology (IT), Clinical Research, Rehabilitation Therapy and Nursing. Education Level ... reviews utilization of mental health and substance abuse services provided in inpatient and ...
Case Manager
Alpharetta, GA · Remote
$19.50 - $25.25/hr
Information Technology (IT), Clinical Research, Rehabilitation Therapy and Nursing. Education Level ... reviews utilization of mental health and substance abuse services provided in inpatient and ...
Full-Time CORE Assistant Clinical Director
Decatur, GA · Remote
$80K/yr
Fully Remote (Georgia Residents Only) Reports To: Executive Director Classification: 1099 ... Review staff productivity, service utilization, and caseload capacity on a regular basis to ...
Quick apply
Full-Time CORE Assistant Clinical Director
Decatur, GA · Remote
$80K/yr
Fully Remote (Georgia Residents Only) Reports To: Executive Director Classification: 1099 ... Review staff productivity, service utilization, and caseload capacity on a regular basis to ...
Full-Time CORE Assistant Clinical Director
Decatur, GA · On-site +1
$80K/yr
Fully Remote (Georgia Residents Only) Reports To: Executive Director Classification: 1099 ... Review staff productivity, service utilization, and caseload capacity on a regular basis to ...
Full-Time CORE Assistant Clinical Director
Decatur, GA · On-site +1
$80K/yr
Fully Remote (Georgia Residents Only) Reports To: Executive Director Classification: 1099 ... Review staff productivity, service utilization, and caseload capacity on a regular basis to ...
Full-Time CORE Assistant Clinical Director
Decatur, GA · Remote
$80K/yr
Fully Remote (Georgia Residents Only) Reports To: Executive Director Classification: 1099 ... Review staff productivity, service utilization, and caseload capacity on a regular basis to ...
Full-Time CORE Assistant Clinical Director
Decatur, GA · Remote
$80K/yr
Fully Remote (Georgia Residents Only) Reports To: Executive Director Classification: 1099 ... Review staff productivity, service utilization, and caseload capacity on a regular basis to ...
LTC Wellness Manager
Atlanta, GA · On-site +1
Review claims history, intake information, engagement signals, and other available data to identify ... Degree in Occupational Therapy, Social Work, Nursing, Gerontology, Case Management, Health Coaching ...
LTC Wellness Manager
Atlanta, GA · On-site +1
Review claims history, intake information, engagement signals, and other available data to identify ... Degree in Occupational Therapy, Social Work, Nursing, Gerontology, Case Management, Health Coaching ...
Sr. Occupancy Planner (Remote)
Atlanta, GA · On-site +1
$100K/yr
As a CBRE Occupancy Sr. Planner, you will provide space planning, data mining, reporting, and ... Review space requirements and provide conceptual plans and recommendations to the real estate team ...
Sr. Occupancy Planner (Remote)
Atlanta, GA · On-site +1
$100K/yr
As a CBRE Occupancy Sr. Planner, you will provide space planning, data mining, reporting, and ... Review space requirements and provide conceptual plans and recommendations to the real estate team ...
Remote Psychiatrist
Atlanta, GA · Remote
$150 - $200/hr
Coordinate with therapists, care navigators, and primary care where indicated * Document within our ... review * Escalate acute safety concerns per protocol, with 24/7 crisis-team backup Practice ...
Quick apply
Remote Psychiatrist
Atlanta, GA · Remote
$150 - $200/hr
Coordinate with therapists, care navigators, and primary care where indicated * Document within our ... review * Escalate acute safety concerns per protocol, with 24/7 crisis-team backup Practice ...
Healthcare Customer Service Representative (Temp-to-Perm)
Atlanta, GA · On-site +1
$15.50 - $21/hr
Together, we provide world-class care in physical therapy, occupational therapy, speech therapy ... Must be able to provide a reliable high-speed internet connection for remote work * Excellent ...
Healthcare Customer Service Representative (Temp-to-Perm)
Atlanta, GA · On-site +1
$15.50 - $21/hr
Together, we provide world-class care in physical therapy, occupational therapy, speech therapy ... Must be able to provide a reliable high-speed internet connection for remote work * Excellent ...
Speech Language Pathology Assistant (SLPA) - Bilingual Spanish
Atlanta, GA · Remote
$41 - $46/hr
... Occupational, Speech, and ABA therapy services, delivering care through virtual, in-home, and ... Responsibilities * Provide remote speech-language therapy services to clients * Implement an ...
Quick apply
Speech Language Pathology Assistant (SLPA) - Bilingual Spanish
Atlanta, GA · Remote
$41 - $46/hr
... Occupational, Speech, and ABA therapy services, delivering care through virtual, in-home, and ... Responsibilities * Provide remote speech-language therapy services to clients * Implement an ...
Advanced Inpatient Coder Specialist (REMOTE)
Atlanta, GA · On-site +1
$21 - $25.25/hr
Remote (must reside in the state of Florida, Georgia, North Carolina, South Carolina) * Status ... HAC reviews. * Strong utilization of anatomy, pathophysiology, and pharmacology knowledge for ...
Advanced Inpatient Coder Specialist (REMOTE)
Atlanta, GA · On-site +1
$21 - $25.25/hr
Remote (must reside in the state of Florida, Georgia, North Carolina, South Carolina) * Status ... HAC reviews. * Strong utilization of anatomy, pathophysiology, and pharmacology knowledge for ...
Remote Psychiatrist Collaborative Physician (MD)
Atlanta, GA · Remote
$25/hr
At the same time, only 30% of therapists accept insurance. UpLift acts as the bridge between ... Complete required chart reviews and provide timely consultation support to NPs. * Maintain ...
Quick apply
Remote Psychiatrist Collaborative Physician (MD)
Atlanta, GA · Remote
$25/hr
At the same time, only 30% of therapists accept insurance. UpLift acts as the bridge between ... Complete required chart reviews and provide timely consultation support to NPs. * Maintain ...
Board Certified Behavior Analyst (In State Remote)
Douglasville, GA · Remote
$85K - $100K/yr
Total Care ABA is a leading provider of in-home and clinic-based ABA therapy throughout Georgia. We ... Review and analyze behavior and skill acquisition data through Central Reach If you're a passionate ...
Quick apply
Board Certified Behavior Analyst (In State Remote)
Douglasville, GA · Remote
$85K - $100K/yr
Total Care ABA is a leading provider of in-home and clinic-based ABA therapy throughout Georgia. We ... Review and analyze behavior and skill acquisition data through Central Reach If you're a passionate ...
Remote Occupational Therapy Utilization Review information
See Decatur, GA salary details
$22.77 - $26.65
2% of jobs
$26.65 - $30.53
3% of jobs
$30.53 - $34.41
8% of jobs
$37.89 is the 25th percentile. Wages below this are outliers.
$34.41 - $38.30
13% of jobs
$38.30 - $42.18
18% of jobs
The median wage is $43.37 / hr.
$42.18 - $46.06
19% of jobs
$48.98 is the 75th percentile. Wages above this are outliers.
$46.06 - $49.95
16% of jobs
$49.95 - $53.83
11% of jobs
$53.83 - $57.71
5% of jobs
$57.71 - $61.60
3% of jobs
$61.60 - $65.48
2% of jobs
$22
$44
$65
How much do remote occupational therapy utilization review jobs pay per hour?
What is a remote occupational therapy utilization review?
A Remote Occupational Therapy Utilization Review job involves evaluating occupational therapy treatment plans and medical records to ensure they meet insurance guidelines and medical necessity. Professionals in this role work remotely to review documentation, provide recommendations, and collaborate with healthcare providers and insurance companies. Their main goal is to ensure appropriate care while preventing unnecessary costs. Strong analytical skills and knowledge of occupational therapy practices and insurance regulations are essential for this role.
What does a remote occupational therapy utilization review do?
Professionals in Remote Occupational Therapy Utilization Review primarily review clinical documentation to determine the medical necessity and appropriateness of occupational therapy services. Typical daily tasks include analyzing therapy notes, applying payer criteria to case reviews, communicating with providers for clarifications, and documenting decisions within electronic systems. You may also participate in team meetings, provide feedback to therapy staff, and stay updated on changing regulations or insurance policies. This role requires a balance of independent work and frequent collaboration with other utilization reviewers, case managers, and healthcare providers to ensure the highest quality of care and compliance.
What are the key skills and qualifications needed to thrive in remote occupational therapy utilization review?
To thrive as a Remote Occupational Therapy Utilization Review professional, you need a background in occupational therapy, solid clinical assessment skills, and familiarity with medical necessity criteria such as Medicare or insurance guidelines. Experience using electronic medical record (EMR) systems, utilization review software, and knowledge of relevant certifications like OTR/L or CHT are typically required. Attention to detail, critical thinking, and strong written communication skills are highly valued in this role. These abilities are crucial to making accurate determinations, maintaining compliance, and effectively collaborating with healthcare teams and insurers from a remote setting.
What are popular job titles related to Remote Occupational Therapy Utilization Review jobs in Decatur, GA?
For Remote Occupational Therapy Utilization Review jobs in Decatur, GA, the most frequently searched job titles are:
What job categories do people searching Remote Occupational Therapy Utilization Review jobs in Decatur, GA look for?
The top searched job categories for Remote Occupational Therapy Utilization Review jobs in Decatur, GA are:
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Full-time
Medical, Dental, Vision, Retirement, PTO
Re-posted 23 days ago
Eversana rating
6.7
Based on 14 frontline employees who took The Breakroom Quiz
63rd of 72 rated business consultants
Job description
At EVERSANA, we are proud to be a Great Place to Work across the globe. We're fueled by our vision to create a healthier world. How? Our global team of more than 6,000 employees is committed to creating and delivering next-generation commercialization services to the life sciences industry. We are grounded in our cultural beliefs and serve more than 650 clients ranging from innovative biotech start-ups to established pharmaceutical companies. Our products, services and solutions help bring innovative therapies to market and support the patients who depend on them. Our jobs, skills and talents are unique, but together we make an impact every day. Join us!
Across our growing organization, we embrace diversity in backgrounds and experiences. Improving patient lives around the world is a priority, and we need people from all backgrounds and swaths of life to help build the future of the healthcare and the life sciences industry. We believe our people make all the difference in cultivating an inclusive culture that embraces our cultural beliefs. We are deliberate and self-reflective about the kind of team and culture we are building. We look for team members that are not only strong in their own aptitudes but also who care deeply about EVERSANA, our people, clients and most importantly, the patients we serve. We are EVERSANA.
*This is a Remote field-based position. Candidates from alternative cities are encouraged to apply but should live in close proximity to a large airport hub.
The National Account Director (NAD) is responsible for implementing a strategic engagement approach at defined accounts within the territory to assure product coverage and access for a first-in-class gene therapy for the treatment of recurrent respiratory papillomatosis (RRP). He/she will identify opportunities and evolving trends that create mutually beneficial collaborations, where patient access to care increases, ultimately improving the quality of care. The NAD is responsible for meeting defined objectives, interactions with targeted accounts, KOLs, Providers, and Administrators in order to understand, educate, and collaborate with key decision makers to drive product understanding and utilization. The NAD is expected to interact routinely and collaboratively with multiple departments and key stakeholders within EVERSANA and our client's organization.
EVERSANA Deployment Solutions offers our employees competitive compensation, paid time off, company paid holidays, excellent training, employee development programs, 401K plan with an employer match, and an incredible list of comprehensive employer benefits that includes medical, dental, and vision insurance along with a whole host of other valuable programs.
ESSENTIAL DUTIES AND RESPONSIBILITIES:
Our employees are tasked with delivering excellent business results through the efforts of their teams. Duties may include, but are not limited to the following:
- Meet or exceed all defined objectives and expense plan goals and objectives, by developing and implementing strategies specific to the assigned account(s)
- Co-Leads the development and execution of the Strategic Account Plans with Commercial Leadership
- Responsible for pull through the payer account plan with Commercial Leadership through routine calls and meetings
- Responsible for the deployment of value-based healthcare commercial resources that challenge account thinking, elevate care and increase utilization of comprehensive care measures in clinical practice leading to improved outcomes of patients with recurrent respiratory papillomatosis (RRP)
- Participate/Co-Lead routine cross functional market meetings focusing on account/customer profiling, performance engagement and accountability
- Ad Boards & Congresses KOL Engagement
- Customer targets include, but not limited to, PBMs, National Health Plans, Medicare MACs, Regional Health Plans, IDNs, Key Customer C-Suite, Directors, Dept. Heads, Administrations, Finance, Pharmacy, Billing, etc.
- Understands role of cross-functional partners and works collaboratively with each function to achieve maximum results
- Demonstrates peer leadership with local field teams, cross-functional partners and internal leadership
- Responsible for elevating the level of engagement between all Client stakeholders at targeted accounts
- Accountable for the development of Strategic engagement opportunities with KOLs within assigned customers
- Provides proactive communication to customer stakeholders (internal and external)
- Gathers insights from aligned Centers and serves as a rapid conduit of information back Commercial Leadership and the broader organization
- Aligns disease state /therapeutic activities to the most current sales and marketing direction
- Conducts Quarterly Business Reviews
- Proficiency with sales support technology - example Salesforce/Veeva
- Strong problem solving and analytical skills
- Demonstrates strong emotional intelligence, strategic focus, ability to build and leverage networks, healthcare business acumen, establish and maintain connections, knowledge of healthcare and managed care policies, knowledge of reimbursement process, and a good understanding of both the Client's product(s) as well as the competition, strategic customer focus, planning ,execution, able to effectively leverage data and information to prioritize business opportunities, balancing stakeholders, business development, impact & influence, decision making, identifying and understanding problems, problem-solving, and thorough understanding of the customer's business environment, able to understand the needs and perspectives of key decision makers.
#LI-CG1
MINIMUM KNOWLEDGE, SKILLS AND ABILITIES:
The requirements listed below are representative of the experience, education, knowledge, skill and/or abilities required.
- Bachelor's Degree from an accredited college/university required
- Minimum 10+ years of pharmaceutical/biotech experience
- 5+ years of current/prior pharmaceutical payer account management and hospital sales experience
- Experience navigating complex accounts critical for success
- Technical knowledge of health care reimbursement from a patient and provider perspective
- Rare Disease, oncology (and/or immunology) with working knowledge of Gene Therapy
- Cell and Gene Therapy experience strongly preferred
- Experience with Buy and Bill drug reimbursement dynamics with payers and Medicare MACs
- Product launch experience, preferably at small to mid-size companies
- Exceptional interpersonal and communication skills to form strong, trusting partnerships to drive performance
- Highly adept in both verbal & written communication; applies advanced presentation skills for the delivery of corporate approved materials
- Advanced business analytical skills to identify trends, opportunities, and threats
- Ability to identify issues quickly and develop recommendations to resolve in a timely, compliant manner
- Knowledgeable in current and possible future policies, practices, trends, technology, and information affecting his/her business and organization
- Ability to clearly and concisely articulate scientific and clinical aspects of disease education & management, mechanism of action (MOA), treatment prescribing information, etc.
- Expert collaboration with cross-functional partners, including marketing, training, operations, medical, etc.
- Familiar with legal and regulatory environment; capable of managing others to operate compliantly
- Comfortable spending ~30%-60% of time traveling; overnight travel required
- Possess valid driver's license and acceptable driving record
OUR CULTURAL BELIEFS
Patient Minded I act with the patient's best interest in mind.
Client Delight I own every client experience and its impact on results.
Take Action I am empowered and hold myself accountable.
Embrace Diversity I create an environment of awareness and respect.
Grow Talent I own my development and invest in the development of others.
Win Together I passionately connect with anyone, anywhere, anytime to achieve results.
Communication Matters I speak up to create transparent, thoughtful, and timely dialogue.
Always Innovate I am bold and creative in everything I do.
Our team is aware of recent fraudulent job offers in the market, misrepresenting EVERSANA. Recruitment fraud is a sophisticated scam commonly perpetrated through online services using fake websites, unsolicited e-mails, or even text messages claiming to be a legitimate company. Some of these scams request personal information and even payment for training or job application fees. Please know EVERSANA would never require personal information nor payment of any kind during the employment process. We respect the personal rights of all candidates looking to explore careers at EVERSANA.
EVERSANA is committed to providing competitive salaries and benefits for all employees. If this job posting includes a base salary range, it represents the low and high end of the salary range for this position and is not applicable to locations outside of the U.S. Compensation will be determined based on relevant experience, other job-related qualifications/skills, and geographic location (to account for comparative cost of living). More information about EVERSANA's benefits package can be found at eversana.com/careers. EVERSANA reserves the right to modify this base salary range and benefits at any time.
From EVERSANA's inception, Diversity, Equity & Inclusion have always been key to our success. We are an Equal Opportunity Employer, and our employees are people with different strengths, experiences, and backgrounds who share a passion for improving the lives of patients and leading innovation within the healthcare industry. Diversity not only includes race and gender identity, but also age, disability status, veteran status, sexual orientation, religion, and many other parts of one's identity. All of our employees' points of view are key to our success, and inclusion is everyone's responsibility.
Consistent with the Americans with Disabilities Act (ADA) and applicable state and local laws, it is the policy of EVERSANA to provide reasonable accommodation when requested by a qualified applicant or candidate with a disability, unless such accommodation would cause an undue hardship for EVERSANA. The policy regarding requests for reasonable accommodations applies to all aspects of the hiring process. If reasonable accommodation is needed to participate in the interview and hiring process, please contact us at [email protected].
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About EVERSANA
Sourced by ZipRecruiter
Industry
Pharmaceutical and medicine manufacturing
Company size
1,001 - 5,000 Employees
Headquarters location
Milwaukee, WI, US
Year founded
2018