Source Job

$95,000–$105,000/yr
US 5w PTO 10w maternity

  • Provide timely medical reviews that meet Cohere’s stringent quality parameters.
  • Clearly and accurately document all communication and decision-making in Cohere workflow tools.
  • Conduct timely peer-to-peer discussions with treating providers to clarify clinical information.

Utilization Review Managed Care Clinical Review

20 jobs similar to Clinical Reviewer, DPT

Jobs ranked by similarity.

US

  • Conduct coverage reviews based on member plan benefits and policies.
  • Document clinical review findings, actions, and outcomes.
  • Communicate and collaborate with providers for benefit determinations.

Capital Blue Cross promises to go the extra mile for their team and community. They foster a flexible environment where health and wellbeing are prioritized and employees consistently vote it as one of the "Best Places to Work in PA."

US

  • Conduct thorough evaluations of patients' functioning to determine their needs and goals.
  • Develop individualized treatment plans and goals for patients based on assessment findings.
  • Provide remote occupational therapy services to help patients achieve their goals.

All Care Therapies utilizes cutting-edge technology to deliver in-home speech, occupational, and physical therapy services for a diverse clientele. They are a leading provider of virtual in-home therapy excelling in addressing the unique needs of each client within their environment.

US

  • Support a fast-growing virtual care team.
  • Transform healthcare and provide accessible care.
  • Provide care to diverse populations across the country.

Included Health is a healthcare company delivering integrated virtual care and navigation. They aim to provide high-quality care for every person in every community, offering care guidance, advocacy, and access to personalized virtual and in-person care.

US

  • Complete timely review of healthcare services using appropriate medical criteria to support determinations.
  • Document clinical findings and rationale clearly and accurately in accordance with federal/state regulations, URAC standards, and Guidehealth policies.
  • Communicate precertification and concurrent review decisions—verbally and in writing—to required parties within defined timeframes.

Guidehealth is a data-powered, performance-driven healthcare company dedicated to operational excellence. Driven by empathy and powered by AI and predictive analytics, Guidehealth leverages remotely-embedded Healthguides™ and a centralized Managed Service Organization to build stronger connections with patients and providers.

US

  • Facilitate 40–50 minute intake calls and brief program check-ins via Zoom
  • Support participants in our 12-week digital program through secure clinical chat
  • Collaborate with our multidisciplinary care team and provide feedback to improve our tools and outcomes

Meru Health is a next-generation digital clinic with a mission to make mental health care more accessible, effective, and outcome-driven. Their 12-week evidence-based program combines licensed therapist support with various practices and digital tools.

US

  • Provide tele-therapy to patients over a HIPAA compliant video conferencing platform
  • Complete clinical case notes in EMR within 48 hours of session
  • Maintain your license information and availability calendar

Headspace provides virtual mental healthcare services, offering therapy and mindfulness tools. They aim to make mental health support accessible, fostering a culture of collaboration and clinical excellence between providers across the US.

Global

  • Use clinical expertise to evaluate AI-generated content.
  • Provide feedback to help AI understand medical knowledge.
  • Review AI responses for clinical accuracy and relevance.

Handshake is connecting students to early talent recruiting. They are an AI company, and provide a platform for matching talent with opportunity.

US

  • Review final 485/POCs for compliance and accuracy.
  • Cross-check orders, goals, frequencies, and documentation.
  • Approve or flag charts for correction.

Urrly uses AI to review every application against the same clear requirements for the role. Their goal is to create a more objective, consistent, and equal opportunity hiring process for all applicants.

US

  • Enter into Written Collaborative Practice Agreements and/or a Collaborate Relationship with the CCS Practitioners, depending on state specific requirements.
  • Provide supervision and collaborative oversight for CCS Practitioners who provide CCS Practitioner Services in the Service Area, consistent with the Collaborative Practice Agreements.
  • Be available to the CCS Practitioner for consultation, as needed, either on site or by electronic access, including but not limited to, telephone, facsimile and email, during normal business hours.

ComplexCare Solutions delivers home assessment services for health plans nationwide. They are committed to equal employment opportunity regardless of race, color, ancestry, religion, sex, national origin, sexual orientation, age, citizenship, marital status, disability, gender identity or Veteran status.

US

  • Provide teletherapy to children ages 0-17, parents, and families.
  • Conduct evidence-based interventions such as Cognitive-Behavioral Therapies and Parent Management Training.
  • Complete clinical documentation using the Little Otter platform for each patient.

Hazel Health & Little Otter deliver expert care for children’s mental health to every home through therapy and psychiatry delivered in a digital platform. They've empowered hundreds of thousands of clients across the country in the healthcare and insurance landscape.

US

  • Review medically complex claims, pre-authorization requests, appeals, and fraud/abuse referrals.
  • Assess payment determinations using clinical information and established guidelines.
  • Evaluate medical necessity, appropriateness, and reasonableness for coverage and reimbursement.

Broadway Ventures transforms challenges into opportunities with expert program management, cutting-edge technology, and innovative consulting solutions. As an 8(a), HUBZone, and Service-Disabled Veteran-Owned Small Business (SDVOSB), they empower government and private sector clients by delivering tailored solutions that drive operational success, sustainability, and growth.

  • Conduct clinical reviews for inpatient admissions and post-acute settings using evidence-based guidelines and CMS criteria.
  • Serve as the primary physician reviewer for escalated or complex cases requiring high-level medical judgment.
  • Partner with care management teams to identify utilization trends and develop interventions to reduce unnecessary admissions or extended stays.

It appears to be a healthcare organization. They ensure timely and appropriate care determinations for their Medicare Advantage members.

Physician

Equip
$250,000–$275,000/yr
US 4w PTO

  • Deliver comprehensive medical assessments and evidence-based treatment for co-occurring medical conditions.
  • Monitor vital signs, labs, and other medical data to ensure medical stability.
  • Collaborate on a multidisciplinary treatment team with medical providers, therapists, dietitians, peer mentors, and family mentors to provide medical guidelines and treatment.

Equip is the leading virtual, evidence-based eating disorder treatment program. They operate in all 50 states and is partnered with most major health insurance plans. Equip has been a fully virtual company since its inception and is proud of the highly-engaged, passionate, and diverse Equisters that have created Equip’s culture.

US

  • Providing evidence-based teletherapy to students and their families.
  • Collaborating with school counselors and other relevant providers.
  • Building trusted relationships with students and families.

Daybreak Health partners with school districts across the U.S. to provide personalized mental health support, helping students reach their full potential. They are driven by their mission to ensure every young person has the foundation for both personal wellbeing and educational success.

US

  • Provide evidence-based teletherapy to students within our school district partnerships.
  • Build trusted relationships with students and their families.
  • Collaborate closely with school counselors and other providers to support student mental health.

Daybreak Health is building a world where every young person has access to the mental health support they need to thrive. As a clinician on their team, you’ll be part of a dedicated, compassionate community of therapists passionate about making a real impact.

US

  • Provide teletherapy services to students in our partner school districts.
  • Collaborate closely with school counselors and other relevant providers.
  • Build trusted relationships with students and families; provide psychoeducation and support to parents and caregivers.

Daybreak Health partners with school districts across the U.S. to provide personalized mental health support, helping students reach their full potential. Their teletherapy programs offer high-quality, affordable, and culturally competent care. They are driven by their mission to ensure every young person has the foundation for both personal wellbeing and educational success.

US

  • Working with a team of Intake Coordinators and Utilization Review Nurses to ensure quality and timely determinations.
  • Striving for continuous improvement and an excellent work-life balance to produce top-notch results.
  • Coordinating and providing care management that is timely, effective, efficient, equitable, safe, and member centered.

Guidehealth is a data-powered, performance-driven healthcare company dedicated to operational excellence. Our goal is to make great healthcare affordable, improve the health of patients, and restore the fulfillment of practicing medicine for providers.

US

  • Provide evidence-based teletherapy to students within our school district partnerships.
  • Build trusted relationships with students and their families.
  • Collaborate closely with school counselors and other providers to support student mental health.

Daybreak Health is building a world where every young person has access to the mental health support they need to thrive. As a clinician on our team, you’ll be part of a dedicated, compassionate community of therapists who are passionate about making a real impact.

US

  • Review and assess asynchronous patient consultations using the ZipHealth, Levity, and RocketRx platforms
  • Prescribe medications safely and appropriately in accordance with clinical protocols, state regulations, and scope-of-practice requirements
  • Maintain accurate, concise, and compliant clinical documentation in English

HeliosX was founded in 2013 with the idea that healthcare should be easier to access, faster to receive, and centered around the individual. They have grown without external funding, scaling profitably through technology, disciplined execution, and deep medical expertise and helped treat over 1.7 million patients worldwide in 2025.

$35–$45/hr
US

  • Providing evidence-based teletherapy to students and families.
  • Collaborating closely with school counselors and other providers.
  • Building trusted relationships with students and families.

Daybreak Health partners with school districts to provide personalized mental health support to students. They are dedicated to ensuring every young person has the foundation for personal wellbeing and educational success, fostering a supportive and inclusive environment.