Physical Therapy Utilization Review Advisor

Physical Therapy Utilization Review Advisor

Empresa: Sedgwick. By joining Sedgwick, you'll be part of something truly meaningful. It’s what our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your career with us, experience our caring culture, and enjoy work-life balance. Here, there’s no limit to what you can achieve. Newsweek Recognizes Sedgwick as America’s Greatest Workplaces National Top Companies Certified as a Great Place to Work® Fortune Best Workplaces in Financial Services & Insurance Physical Therapy Utilization Review Advisor PRIMARY PURPOSE : Counsels providers (physical therapists, occupational therapists, and physicians) as it pertains to the appropriate use, cadence, and duration of physical therapy services; monitors the impact of physical therapy services provided to injured workers; provides medical necessity reviews to evaluate and implement services to meet client health needs; and promotes quality cost-effective physical therapy outcomes. ARE YOU AN IDEAL CANDIDATE? We are looking for enthusiastic candidates who thrive in a collaborative environment a are driven to deliver great work. ESSENTIAL FUNCTIONS and RESPONSIBILITIES - Reviews medical records and physical therapy (PT) treatment plans to ensure they meet the appropriate guidelines while also ensuring best possible recovery. - Determines the medical necessity and appropriateness of physical therapy services according to policy and develops action plans for providers as it pertains to current and future treatment. - Provides clinical opinions regarding physical therapy needs and communicates with providers about therapy protocols and guidelines. - Liaises and negotiates with physical therapists, occupational therapists, physicians, and other stakeholders to optimize patient care and promote effective use of resources. - Consults with Sedgwick clinical team on difficult claims and provides recommendations tied to improving care and overall claim outcomes. - Supports cli