How can PTAs and OTA/COTAs work in Utilization Review?

Can physical therapy and occupational therapy assistants work in Utilization Management? The answer is 100% yes!!!

You may be wondering how to find utilization management roles as an assistant, what do assistants make in these care coordinator, utilization review, utilization management, and who is hiring assistants for these roles? 

Welcome to this guide that will walk you through how as a therapy assistant, you can get a role within utilization review/utilization management!

1. How much can physical and occupational therapy assistants make in utilization review?

The salary for assistants does vary based on role and company, but you can expect to earn between $65,000 - $80,000. 

For PT and OT assistants, the salary ranges a little more than therapists because there are so many different roles and different titles you would apply for  - Elevance hires assistants for therapy reviewers (their version of a utilization reviewer) and that salary is between $27-36 per hour but there's also clinical assessor, patient care navigator, field based navigator roles. I recommend you be more prepared for pay that is similar to your clinical salary as an assistant and around $65,000-$80,000 ranges. 

You'll also have full benefits including health benefits, PTO, raises and bonuses! 

What's also neat is that in many of these roles, there is room for upward and lateral movement within the company!

2. How to stand out in your utilization review application as a PT or OT assistant? 

There are several quick and easy ways to stand out in your applications for utilization review related roles. The first is to make sure your resume is updated and really relevant to any position you are applying for. The second is to make sure you have attached a cover letter - I know it takes extra effort but it really has made a difference including one for our students. Make sure you submit your applications in PDF format, but we all knew that one already. 

But beyond this, my top advise is to level up your skills! How can you gain more experience in different settings? How can gain more education on billing, documentation, insurance regulations? How can you gain more experience performing public speaking or in-services? 

I would highly recommend you look into our Foundations of Utilization Management Certificate that will help you in the following ways:

1. You can put this on your resume and cover letter to help you stand out and prove you know this role and are ready to perform it.

2. This course provides you with all the resume, cover letter, follow up templates you'll need.

3. In our course, we will provide you with free resume editing to make sure you have the best resume possible for your application as well as monthly job notifications. 

4. Our course provides 7 hours of CEU credit approved by the AOTA as well as over 30 PT states.

5. Our course includes step by step video guides on job searching, applying, resume and cover letter editing, LinkedIn, interviewing, CMS guidelines, how to perform utilization review, and so much more! Everything is specific to UM roles and we have it so that each section has specific content for therapists, nurses as well as assistants.  

6. Amazing student Facebook group as well as super fast support via chat, Facebook, or email. 

We have weekly success stories and have had over 800 happy students!

You can read more about our Foundations of Utilization Management Certificate here: https://www.alternativehealthcarecareers.com/courses/becomeautilizationreviewer and feel free to email us at [email protected] if you have any questions! 

 3. Who hires therapy assistants for utilization review roles?

First, I highly recommend you search on Indeed and LinkedIn and do not solely rely on this list, but also more broader searchers. Many of our assistant students have achieved roles in utilization review within independent hospitals and organizations in addition to this list. 

But here is a short list of companies that hire therapy assistants:

• Elevance

• naviHealth/UnitedHealth Group

• Magellan

• MyNexus

• CareBridge Health

• Limber Health

4. What is a day in the life of an assistant in Utilization Review/Utilization Management?

Your day can really vary as there are a variety of roles you could work as and as a result there may be some variation. 

 But usually your day is a standard 8 hour day, but note that time zone and times required may vary - usually you'll know the exact hours before you apply for the role. 

These roles are often fully remote. 

These roles are typically a combination of reviewing therapy documentation for appropriateness of care, calling providers to gather more information, answering questions or calls from providers in regards to authorization and utilization review questions, working with your team on patient charts to determine appropriateness of therapy treatment that was submitted or appropriateness of requested facility admission, and documenting your decision. Note that you are never the final decision maker. This rests on the physician on your team.  

Some roles will have more care coordination, liaison type of roles where you are really advocating for the patient and guiding them through their recovery journey. 

5. Can I work part time in utilization review as an assistant?

YES! Not all companies hire for part time roles but we have a list of companies that do and it is 100% possible. I will say per diem and contract roles are more uncommon than part time and full time roles. 

6. Why are Utilization Reviewer roles the best remote role for PT and OT assistants?

 I am a huge advocate of therapists and physical and occupational therapy assistants getting utilization review roles because it has been life changing to our students! Here are just some reasons both myself and our success stories love utilization review as a remote non clinical job:

• Stable career route, no flex off!
• Upward and lateral movement
• Great pay, PTO, raises, bonuses and other benefits
• Supportive company culture (especially UnitedHealth Group)
• Work remote full time - less stressful, no physical demands, save so much time and energy not commuting
• Once you are done with your day, you are done! No take home work (unless you want, and then they give you overtime for your time)
• Non physical work
• No extra education needed for the role, they help train you (paid training btw)

 Join our utilization review certificate and CEU course today and get the jump start you need to leave patient care and live the life you deserve! 

I sincerely hope this article has give you hope and inspired you to take the leap into a remote role, and perhaps a remote role in utilization review! 

We encourage you to check out our amazing utilization review certificate here: https://www.alternativehealthcarecareers.com/courses/becomeautilizationreviewer which includes 7 CEU hours, free resume editing, step by step video training, interview questions and answers, all the templates you'll need, cover letter and resume examples, and 2 hours of training how to actually perform utilization review! 

 Proof of successful therapy assistant students: