From SLP to Utilization Reviewer: Four Steps to Getting Hired

utilization review Nov 09, 2021
speech-therapist-to-utilization-reviewer

From SLP to Utilization Reviewer: Four Steps to Getting Hired

 

Are you an SLP looking to transition to Utilization Review? Welcome to the journey! Utilization Review (UR) is a great alternative career option if you want a stable, remote way to use your education and license. Fortunately, more and more companies are recognizing the value of SLPs in addition to PTs and OTs in ensuring that rehabilitation services are utilized appropriately. 

 

As an SLP who was successfully hired as a Utilization Reviewer at a major healthcare company in 2020, I’m here to share my roadmap for standing out from the pack. PTs and OTs: these strategies can also be useful for you, but because there are (unfortunately) fewer UR openings for SLPs, the speech and swallowing experts of the world may find them particularly useful for gaining that invaluable edge over the competition. 

 

No matter your discipline, remember that your path to UR is uniquely your own, and that patience is key. Many of our students have landed a position only after sending many, many applications. And don’t forget - we’re always here to answer your questions! 

 

  1. Adjust Your Application For Each Position

 

Each UR role and company will be different, so read each job description carefully. If you have questions about a particular role, the AHC Facebook group is a great place to ask, as are other Facebook groups tailored specifically to SLPs (“SLP Transitions” is where I got started on my path).

 

To give you a sense of the variety of UR positions: Some reviewers only look at documentation while others also take phone calls from providers in a call center environment. Care coordination is also a big part of some jobs. The particular set of daily tasks involved in the UR role depends on the company and setting -  so read the job description carefully and make sure you’re truly interested.

 

Once you’ve decided to apply, glean as many concrete details and keywords as possible from the job posting, and adjust your resume accordingly. For example, if the job does require you to take calls from providers, emphasize your customer service and collaboration skills. If the job requires care management and coordination, illustrate your role at interdisciplinary care team or IEP meetings. Keep in mind that you will rarely only review SLP cases, so emphasize your interdisciplinary work with PT and OT. 

 

 

Use Tools to Optimize Your Resume

 

You probably already know that there’s nothing less impressive to a hiring manager than a generic resume and cover letter. Investing a little time into learning about the company’s unique mission and highlighting how your particular skills will bring value will go a long way to getting you past that first step in the application process. 

 

At first, tailoring your resume to each position can feel like a daunting and time-consuming process. But a great place to start is keywords. Fortunately, there are lots of tools out there to help you determine if your resume and cover letter incorporate enough crucial keywords and touchpoints. One example is https://www.jobscan.co — I just use the “Try Sample Resume and Job” to copy and paste the text of my resume and of the job description. This tool shows how much of a “match” your resume is to the job. There may be other useful paid features as well, but I’ve never tried them. 



  1. Get Your Resume Professionally Reviewed

 

Even if you feel like you’ve perfected your resume and cover letter, it’s so important to have somebody trustworthy look over it. They should review it not just for formatting and spelling errors, but most importantly for how you are tailoring your past experience to fit the role’s requirements. 

 

Although you may not want to take on the additional expense, this relatively small investment can make a world of difference in actually getting to the interview stage where you can really shine (especially if you follow strategies #3 and #4!). And if you really can’t spare the money, ask a trusted friend to take a glance. Even if they’re not familiar with the field and can’t weigh in on the content, they might catch spelling and formatting errors that you simply missed in your hours of agonizing over it (somehow it happens!)

 

By the way, I’m a firm believer that it’s totally unnecessary to list every single SLP experience you’ve ever had. In my case, a 1-2 page resume certainly does not have enough room for every single one of the 10+ per diem positions I’ve held in the past, even if I distill them all into just one line. So, I picked the most salient roles as well as the most relevant of my “side” hustles – including my work as a remote patient care coordinator for an outpatient clinic (if you’ve done any chart auditing, billing, insurance coordination, make sure you include that). My resume is one of the samples on the AHC course resource page - so head over there to check it out!

 

The great news is that the UR course now contains one free resume review by Polish 2 Prosper (a $99 value). This wasn’t offered when I was a student, but it sure would have saved me a lot of time, hassle, and self-doubt to have an experienced professional provide some feedback.



  1. Learn Some Basic UR Principles

 

It’s much easier to stand out from the pack if you demonstrate that you’ve already put in the time and effort to learn about the field. Towards that end, the AHC Utilization Reviewer course is provides an in-depth glimpse into UR processes and is geared specifically towards rehab professionals who are serious about making the leap. In addition to the 2-hour course, it contains an absolute treasure trove of resources like sample resumes, cover letters, interview questions, email templates, and much more. On top of that you get professional resume review AND access to the Facebook group, where you can ask questions and interact with other therapists who are in the same boat or who have already been hired.



Once you’ve finished the course, I’d recommend digging further into the clinical utilization criteria of the particular company you’re applying for. These are usually public and can be found by googling some combination of  “Company Name rehabilitation clinical criteria/coverage determination guidelines/appropriate use criteria.” Read through the criteria and get a sense of the major takeaways, but don’t worry about memorizing them. Instead ask yourself -what are the major factors of medical necessity that this company uses to determine if therapy is medically necessary? Work these terms into your cover letter (without going overboard). Remember though,most companies will train you for at least 1-2 months and in my experience, not a whole lot of specific and detailed prior knowledge is assumed beyond what you already know as a clinician. So don’t sweat the small stuff.

 

[Should we link to some clinical guidelines here? UHC, EviCoreand Aim Specialty Health/Anthem guidelines are readily available online. Or maybe we can save that for a separate post - this could also make useful course content for people applying to specific companies] 

 

Other UR professionals recommend digging into CMS guidelines to get a firm grasp on Medicare rules and regulations. My own take is that as an SLP, you probably already understand the basic gist of Medicare if you’ve worked for any length of time in the medical setting, although if you’re coming from schools, brushing up might help). But if you want a refresher, the Nurse.com course is helpful although it contains much more detail than you’ll ever need to know in practice. 

 

I loved taking courses because spending the money and made me accountable to that commitment and made me less likely to prioritize other stuff. It’s sort of like buying a yoga pass for a studio versus just telling yourself you’ll do yoga at home. No matter what course(s) you complete, don’t forget that you can include the course completion certifications in your job application materials (I put mine in the same PDF as my cover letter).

 

 

  1. Practice Talking about UR

 

If you are selected as a potential candidate based on your resume, you will be invited to interview. It’s absolutely natural to be nervous —I’d be concerned if you weren’t — but it’s important to seem articulate and confident, especially if the job involves communicating with providers or patients. Obviously, comfort with UR principles comes with on-the-job training, but it’s still important to leave a strong interpersonal impression on your interviewer.

 

To prep for the interview, it’s helpful to start by talking to yourself in a mirror. Work on speaking clearly and naturally and don’t over-rehearse. I’ve included some sample questions for you to work on below. Be sure to also check out the sample interview questions on the AHC course resources, which contain more “behavioral” questions that are not necessarily specific to the field. I literally wrote out my answers to the most common questions and practiced responding aloud  3-5 times the day before my interview. There are also fantastic interview tips on LinkedIn Premium.

 

A Non-Exhaustive List of Interview Questions to Practice:

 

  • What clinical factors determine whether a patient will benefit from continuing therapy?
  • What are some components of functional, measurable goals? (Hint: think back to the SMART acronym we all learned in graduate school)
  • What might cause a patient to plateau or regress during therapy? And how can a plan of care be adjusted to continue demonstrating value even in the absence of measurable gains?
  • When is it appropriate to discharge services for somebody with a chronic condition that may or may not progress despite medical and therapeutic intervention? 
  • How can your clinical experience translate into working effectively on a UR team?

 

Most of all, Be Patient:

 

In this process, having patience is just as important as putting in the nitty gritty work. Hiring decisions, especially at huge companies, can be cryptic. But the good news is that UR seems to be continually expanding as a field - so stay patient, keep working, and know that the right alternative career for you is out there!















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