Utilization Mgmt PT / OT Thr Spc

Job Description

Job Description

Utilization Management PT / OT Therapy Specialist

Location : Houston, TX

Pay Rate : $48 / hr

Shift : Monday-Friday, 8 AM-5 PM (Hybrid; onsite required for training, team meetings, town halls, and during internet / power outages)

Dean's Professional Services is actively seeking a Utilization Management PT / OT Therapy Specialist. This role is responsible for providing prior authorization for outpatient and home physical and occupational therapy services requiring approval. Responsibilities include applying clinical judgment for utilization management, interpreting product benefits, ensuring regulatory compliance, verifying medical necessity using evidence-based criteria, and providing provider education as needed.

Responsibilities :

• Utilize established criteria to certify requested services within required timeframes.
• Consult with physicians and therapists regarding member history and current care needs.
• Refer cases that do not meet medical necessity criteria to the medical director or designee.
• Enter information into systems in a timely manner, assign appropriate length of service based on guidelines, and communicate authorization numbers to providers and members.
• Evaluate benefit coverage and regulatory guidelines relevant to authorization decisions.

Qualifications :

Education (Required) :

Certifications & Licensure (Required) :

Experience :

Required Skills & Abilities :

Why Join Us?

Dean's Professional Services is a national, award-winning staffing solutions firm. Since 1993, DPS has placed over 50,000 professionals across the nation. We match talent with opportunity - focusing on skill, experience, and culture fit.

Apply today at or call for more information.