Remote Physician Reviewer

Job Summary

A healthcare company has an open position for a Remote Physician Reviewer.

Candidates will be responsible for the following:

• Conducting utilization reviews for medical necessity determinations
• Conducting medical necessity review on cases that may not meet criteria
• Achieving Service Level Agreement metrics and performance guarantees as required by health plan clients

Qualifications Include:

• MD or DO with an active and unencumbered medical licenses
• Appropriate current and unexpired specialty board certifications
• 3-5 years experience in clinical practice
• 3-5 years experience doing utilization review