Rheumatology Physician Reviewer

Job Summary

A company is looking for a Physician Clinical Reviewer - Rheumatology - REMOTE.

Key Responsibilities

• Reviews cases requiring clinical determinations that cannot be made by the Initial Clinical Reviewer
• Discusses determinations with requesting physicians or ordering providers within regulatory time frames
• Provides clinical rationale for standard and expedited appeals and assists Initial Clinical Reviewers as needed

Required Qualifications

• Education Level: DO, MBBS, or MD
• Experience Level: 5+ years in a clinical setting
• Must be eligible to work in the United States without the need for work visa or residency sponsorship