Physical Therapist, Prior Authorization - Telecommute in Mas - (Springfield, MA)

For those who want to invent the future of health care, heres your opportunity.Were going beyond basic care to health programs integrated across the entire continuum of care.Join us and help people live healthier lives while doing your lifes best work.(sm) ***This is a telecommuter position, but preference is that the individual live in the state of Massachusetts and close to 1 of the offices in the Boston area*** Main responsibilities: Responsible for performing prior authorization review of services that require notification, using applicable benefit plan documents, evidence - based medical policy and state specific recognized clinical guidelines and criteria Determines medical appropriateness of provider services following evaluation of medical guidelines and benefit determination Interacts with providers to obtain clinical info to support prior authorization determinations and provide support for their questions Evaluate applicability of community resources / government programs / LTSS provider services