Location & Practice Overview

This utilization management role is based in an office setting in Austin, Texas, supporting therapy authorization work for health plan clients through structured clinical review processes.

Base Location Austin, TX
Department Utilization Management / Therapy Authorization
Practice Type Healthcare staffing and managed services
Care Setting Office-based review of electronic patient records
Patient Access Model Varies by client health plan membership

Responsibilities

  • Conduct clinical review of therapy authorization requests against client-specific medical necessity criteria.
  • Assess member functioning at home, work, and in the community using clinical documentation provided in the request.
  • Verify eligibility, benefits, and medical policy compliance while evaluating appropriateness of the proposed treatment setting for pre-service, concurrent, and retrospective reviews.
  • Identify cases that may benefit from early intervention or proactive therapy planning.
  • Process service requests through electronic systems, phone, and fax, and place outbound calls to providers when additional clinical information is required.

The work centers on evidence-based authorization decisions that support appropriate access to physical, occupational, and speech therapy services while aligning with benefit plan guidelines.

Qualifications & Requirements

Candidates must hold an active Texas therapy license and bring solid post-licensure clinical experience. Prior authorization background is preferred but not required.

Education
Bachelor’s degree or higher in Physical, Occupational, or Speech Therapy from an accredited program
License
Current, unrestricted PT, OT, or ST license in the State of Texas
Experience
Minimum 2 years post-licensure clinical experience in a hospital, clinic, or agency setting
Technical Skills
Basic computer proficiency with ability to learn new systems quickly
Communication
Strong verbal and written English communication skills
Screening
Must pass background check and drug screen

Compensation & Benefits

Base salary is offered within the stated annual range and is commensurate with experience. Additional performance incentives are available based on productivity and quality metrics.

  • Base salary: $88,000–$108,000 annually
  • Performance incentives tied to productivity and quality
  • Health, dental, and vision coverage options through BCforward
  • 401(k) retirement plan with company match
  • Paid time off and holiday pay
  • Professional license maintenance support

Schedule & Work Environment

Work Week Monday–Friday, standard daytime hours
Call None
Work Model Office-based in Austin
Patient Care No direct patient care; review-based only
Documentation Systems Electronic health records and utilization management platforms

Patient Population & Clinical Setting

Reviewers evaluate therapy service requests for members of various health plans. The clinical focus covers both adult and pediatric populations depending on client contracts, with emphasis on medical necessity and appropriate care settings.

Age Groups Adult and pediatric, depending on client contracts
Common Focus Areas Post-surgical rehabilitation, chronic condition management, developmental therapies
Review Types Pre-service, concurrent, and retrospective
Clinical Emphasis Balancing clinical appropriateness with benefit plan guidelines

About BCforward

BCforward is a national talent and technology solutions partner founded in 1998 and headquartered in Indianapolis, Indiana. The organization delivers staffing, workforce solutions, and managed services across multiple industries, including healthcare, with a focus on regulated environments and measurable outcomes.

Organization Type Workforce solutions and staffing partner
Founded 1998
Headquarters Indianapolis, Indiana
Service Area National, with delivery centers across North America
Recognition MBE certified firm

Frequently Asked Questions

Is prior authorization or utilization management experience required?
It is preferred but not required. Strong clinical experience as a licensed therapist is the primary qualification. Comprehensive onboarding on client-specific guidelines and systems is provided.
Will I provide any direct patient care in this role?
No. This is a fully office-based utilization management position focused on clinical review of electronic records and prior authorization of therapy services.
Which therapy licenses are accepted?
A current unrestricted Physical Therapy (PT), Occupational Therapy (OT), or Speech Therapy (ST) license issued by the State of Texas qualifies for the role.
How is review volume managed?
Volume varies by client contracts and is structured to support focused, high-quality clinical decision-making rather than high-throughput quotas.
Is the position remote or hybrid?
The role is office-based in Austin, Texas, with expectations for on-site collaboration and workflow efficiency. It is not listed as fully remote.

Therapy & Authorization Specialist: Physical Therapy in Austin, TX

Licensed therapists seeking a non-clinical application of their expertise will find a focused utilization management path in this Austin-based role. The position centers on evaluating medical necessity for physical, occupational, and speech therapy services across health plan members, applying clinical judgment to authorization decisions without direct patient interaction. Reviewers work from electronic records in an office environment, assessing functioning, treatment settings, and benefit compliance for pre-service through retrospective requests. The structure supports therapists who prefer analytical work, structured criteria application, and collaboration with medical directors on complex cases while maintaining Texas licensure. This arrangement offers a clear alternative to traditional clinical practice for those interested in payer-side operations and therapy authorization processes.

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