Arkansas Licensed Physician Reviewer

Job Summary

Contracting with physicians to perform prior authorizations and retrospective reviews, the occasional External Physician Reviewer will work from home, completing reviews for Medicaid services while utilizing a clinical review platform.

Key responsibilities

• Conduct initial and reconsideration reviews for prior authorizations and retrospective assessments
• Utilize AFMC ReviewPoint for clinical reviews, ensuring compliance with service standards
• Complete reviews for various medical specialties, including hospitalist, ENT, and oncology services

Required qualifications

• Active, unrestricted medical license in Arkansas
• Board certification in a relevant specialty
• Minimum of five years of full-time equivalent direct patient care experience
• Direct patient care experience within the last three years
• Current liability and malpractice insurance coverage for non-UR clinical activities