Job Description

Job Title: Physical Therapist UR QI Specialist, Full-Time
Job ID: 14905552
Status: Full-Time
Regular/Temporary: Regular
Hours:
Shift: Day Job
Facility: Centers for Rehab Services
Department: Compliance
Location: 625 Walnut Street, Mckeesport PA 15132

Description

UPMC Centers for Rehab Services is currently hiring a full-time Physical Therapist UR QI Specialist. The candidate will work Monday - Friday, 8:00 a.m. - 4:30 p.m.  The candidate will be 80% remote and 20% at the McKeesport Corporate office. If this sounds like a good fit for you, we invite you to apply!


Purpose:
The Utilization Review Specialist is involved with all ongoing activities related to the development, implementation, and maintenance of Utilization Review processes in conjunction with the Director of Quality Improvement, Utilization Review & Safety and the Vice President of Compliance and Quality. The Utilization Review Specialist is responsible for monitoring compliance with documentation standards, as well as assisting with the development and implementation of tools used for service evaluation. The Utilization Review Specialist is responsible for maintaining effective communication with the Director of Quality Improvement, Utilization Review & Safety.

Responsibilities:

  • Maintain a high-level of confidentiality in all activities.
  • Provide feedback in constructive manner;
  • Update content on the organization?s intranet site for the sharing of utilization review related documents;
  • Attends the following meeting: corporate compliance committee, billing supervisors, and compliance team meetings as requested;
  • Serve as a utilization review consultant to other UPMC rehab entities as requested;
  • Prepare reports with assistance from the department?s Senior Programmer;
  • Collaborates with external experts/consultants as needed;
  • Engage IT and Billing support to address compliance related concerns with the electronic health record;
  • Responsible for updating content on the utilization review form to address areas of risk in collaboration with the Director, Policy & Audit Management and the VP, Compliance & Quality;
  • Develop comprehensive education and training to address negative trends identified through the utilization review process;
  • Collaborate with operational leadership to address staff not meeting documentation expectations;
  • Responsible for the communication of documentation errors and collaborate with operational leadership to correct such errors in a timely manner;
  • Audit and monitor documentation, through Epic reporting, to identify errors of incomplete or missing documentation;
  • Review and/or revise utilization review policies and procedures annually at a minimum;
  • Participate in education and training to keep current with all third-party payer documentation requirements;
  • Responsible for the development, implementation, and oversight of the utilization review program;
  • Performs all other compliance and quality related duties as requested

 

Qualifications

  • Graduate of a school of Physical Therapy approved by the American Physical Therapy Association with a Bachelor of Science Degree or Master's Degree in Physical Therapy or Bachelor's degree in related field with a certificate of proficiency in Physical Therapy

    Licensure, Certifications, and Clearances:
  • Act 33 Child Abuse Clearance
  • Act 34 Criminal Clearance
  • Act 73 - FBI Physical Therapist
  • CPR required based on AHA standards that include both a didactic and skills demonstration component within 30 days of hire

  • Basic Life Support (BLS) OR Cardiopulmonary Resuscitation (CPR)
  • Physical Therapist (PT)

  • UPMC is an Equal Opportunity Employer/Disability/Veteran

     

    Salary Range: $29.44 to $46.31 / hour

    Union Position: No

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