Licensed RN Physician Review Coordinator

Job Summary

A company is looking for a Physician Review Coordinator.

Key Responsibilities

• Initiate and oversee the physician-level review process with Independent Review Organizations
• Conduct medical necessity reviews using evidence-based medical criteria as needed
• Manage workload effectively to meet customer and business needs

Required Qualifications

• Active RN License required
• Minimum three years of experience in a clinical setting
• Active MCG UM/CM Certification or ability to obtain within 6 months of hire
• Willingness to adapt to changing business needs
• Utilization Management, Case Management, or Claims experience preferred