Responsible for clinically reviewing request for Speech services in a timely manner utilizing established clinical guidelines and Utilization Management protocols to evaluate for the medical necessity and appropriateness of the requested ST services. Responsible for making organizational determination and escalating cases deemed not medically necessary to the Medical Director. Performs Peer to Peer discussions with requesting providers.
Licensed Speech Therapist in Puerto Rico. Also, candidates must be able to apply and successfully obtain their License within 6-12 months from date of hire for the States of FL, GA, NJ and any other State the Company conducts business in.
Not applicable to this position.