To include; attending Utilization Reviews and reports as necessary (including managing medical ... Clinical licensure required (PT, OT, SLP or RN preferred). Other licensure/certification to be ...
To include; attending Utilization Reviews and reports as necessary (including managing medical ... Clinical licensure required (PT, OT, SLP or RN preferred). Other licensure/certification to be ...
To include; attending Utilization Reviews and reports as necessary (including managing medical ... Clinical licensure required (PT, OT, SLP or RN preferred). Other licensure/certification to be ...
To include; attending Utilization Reviews and reports as necessary (including managing medical ... Clinical licensure required (PT, OT, SLP or RN preferred). Other licensure/certification to be ...
Slp Utilization Review information
What are the key skills and qualifications needed to thrive as an SLP Utilization Review specialist, and why are they important?
To thrive as an SLP Utilization Review specialist, you need a background in speech-language pathology (usually a master's degree and ASHA certification) and strong knowledge of clinical documentation and regulatory guidelines. Familiarity with electronic health records (EHRs), utilization management software, and insurance approval systems is typically required. Excellent analytical skills, attention to detail, and effective written and verbal communication are essential soft skills for success in this role. These abilities ensure accurate assessments, compliance with standards, and efficient coordination between providers, payers, and patients.
What is an SLP Utilization Review?
An SLP Utilization Review refers to the process in which a Speech-Language Pathologist evaluates the necessity, appropriateness, and efficiency of speech therapy services provided to patients. This review is conducted to ensure that care meets established clinical guidelines and that resources are used effectively. SLPs in this role often review patient records, collaborate with healthcare teams, and make recommendations regarding ongoing therapy or discharge. The goal is to support high-quality patient care while controlling costs and meeting insurance or regulatory requirements.
What are some common challenges Speech-Language Pathologists face during the utilization review process, and how can they address them?
Speech-Language Pathologists (SLPs) in utilization review often encounter challenges such as interpreting complex insurance guidelines, managing high caseloads, and ensuring thorough documentation that supports medical necessity. Navigating the variations in payer requirements can be time-consuming and requires meticulous attention to detail. To address these challenges, SLPs should stay updated on payer policies, engage in regular training, and collaborate with clinical teams to ensure their documentation aligns with the latest standards. Effective communication skills and ongoing education are key to successful case reviews and approvals.
What are popular job titles related to Slp Utilization Review jobs in Wisconsin? For Slp Utilization Review jobs in Wisconsin, the most frequently searched job titles are:
- Utilization Review Physician
- Remote Utilization Review Nurse
- Remote Prior Authorization Nurse
- Clinical Reviewer
- Utilization Management Nurse
- Seasonal Remote Hedis Review Nurse
- Utilization Review Nurse
- Part Time Utilization Review Nurse
- Commission Cvs Health Utilization Management
- Remote Utilization Management
What job categories do people searching Slp Utilization Review jobs in Wisconsin look for? The top searched job categories for Slp Utilization Review jobs in Wisconsin are:
- Dental Utilization Review
- Remote Aetna Utilization Review
- Optum Utilization Review Nurse
- Remote Occupational Therapy Utilization Review
- Insurance Utilization Reviewer
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- Anthem Utilization Review Nurse
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- Fulltime Cigna Utilization Review Nurse
What cities in Wisconsin are hiring for Slp Utilization Review jobs? Cities in Wisconsin with the most Slp Utilization Review job openings:
Full-time
Medical, Dental, Vision, Retirement
Posted 26 days ago
Job description
Our hospital provides high-quality care that transforms the lives of those living with disabling injuries and illnesses. We distinguish ourselves through our commitment to excellence, to our patients, to our employees, and to the communities we serve.
We're proud to announce the Winter 2026 grand opening of ClearSky Rehabilitation Hospital of Eau Claire, WI!
As we prepare to open our doors, we're seeking a passionate and experienced Director of Patient Outcomes to join our founding leadership team. This is a unique opportunity to help shape clinical quality, performance improvement, and patient safety at a brandnew, stateoftheart rehabilitation hospital.
If you're a dedicated clinician driven to improve patient outcomes and make a meaningful impact, you'll find a rewarding career with a growing healthcare organization committed to excellence in patientcentered care. We invite you to be a vital part of our journey from the very beginning.
Click here to watch a video and learn more about what it is to be a part of the ClearSky Rehabilitation team.
🌟 What We Offer: Your Path to a Rewarding Career Starts Here! 🌟
- Competitive Compensation
- Comprehensive Benefits Package including Medical, Dental, Vision
- 401k Matching
- Student Loan Repayment and Tuition reimbursement
- Professional Development Opportunities to include CEU Opportunities
- Health and Wellness Programs
- Career Advancement
- Inclusive and Supportive Culture
- Work Life Balance
- Employee Recognition Program
Our Director of Patient Outcomes is responsible for directing the completion of the Inpatient Rehabilitation Facility Prospective Payment System (IRF PPS). Provides clinical support in completion of data contained in prospective payment system (PPS) and functional outcome measure (FOM) instruments for each patient to ensure accuracy in the scoring of functional status and reflection of the patient's care needs.
Job Duties include, but are not limited to:
- Lead and direct the case management department as assigned, to include: management of staffing needs, and caseloads; education, direction, and mentorship of the Case Management Team, and reporting and assistance in the management of patient outcomes.
- Reports and assists in management of patient outcomes. To include; attending Utilization Reviews and reports as necessary (including managing medical necessity denials), collecting data and monitors Quality Indicators and the Care Tools, maintains FOM credentialing and staff education as well as FOM functions, ensuring accuracy (rounds, education, certification, etc.), reviewing physician documentation for medical necessity and function changes and tracks Compliancy (CMS13) and assists in attainment of required documentation from clinical liaison's and physicians to support.
- Attends Operations/Admissions meetings and reviews patients for tiers and compliance. As well as attending team conferences and assisting Health Information Management (HIM) with accuracy of coded tiers with queries.
Requirements for consideration:
- Clinical licensure required (PT, OT, SLP or RN preferred). Other licensure/certification to be considered based on appropriate qualifications.
- Two years of recent experience in acute care setting preferred
- Must maintain acceptable driving record, current driver's license and insurability
We value our employee's skills, talents and input. We believe in maintaining hospital environments where employees are valued, treated with dignity, respected, provided educational and training opportunities recognized and rewarded. These values are included in our competitive and comprehensive compensation and benefits.
About ClearSky Health
Sourced by ZipRecruiter
Industry
Health care and social assistance
Company size
51 - 200 Employees
Headquarters location
Albuquerque, NM, US
Year founded
2018