Job Summary
A healthcare company has an open position for a Remote Board Certified Physical Medicine and Rehabilitation Utilization Review Physician in Santa Rosa.
Individual must be able to fulfill the following responsibilities:
- Reviewing medical files and providing recommendations for utilization review, chart reviews, medical necessity, etc
- Returning cases in a timely manner with clear, concise, and complete rationales and documented criteria
- Telephonically contacting providers and interacting with other health professionals in a professional manner
Applicants must meet the following qualifications:
- Board certified MD, DO
- Excellent understanding of network services and managed care
- Current, unrestricted clinical license(s)
- Board certification by American Board of Medical specialties or American Board of Osteopathic Specialties
- Must be in active medical practice to perform appeals
- Post-graduate experience in direct patient care
