Job Summary
A healthcare company is searching for a person to fill their position for a Remote Orthopedic Surgery Utilization Review Physician in Greenwood Village.
Individual must be able to fulfill the following responsibilities:
- Telephonically contacting providers and interact with other health professionals in a professional manner
- Reviewing medical files and provide recommendations for utilization review
- Returning cases in a timely manner with clear concise and complete rationales and documented criteria
Applicants must meet the following qualifications:
- Ability to attend orientation and training onsite
- Board certified MD, DO, with an excellent understanding of network services and managed care, appropriate utilization of services and credentialing, quality assurance and the development of policies that support these services
- Board certification by American Board of Medical specialties or American Board of Osteopathic Specialties
- Must be in active medical practice to perform appeals
- Current, unrestricted clinical license(s)
- Post-graduate experience in direct patient care
