State Licensed Endocrinology Physician Reviewer

Job Summary

A company is looking for a Physician Clinical Reviewer - Endocrinology - 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

• Doctor of Medicine (MD), Doctor of Osteopathic Medicine (DO), or equivalent international degree with completion of U.S. internship and residency
• Current, unrestricted medical license in one or more U.S. states
• Board Certified by an appropriate medical board
• Minimum of 1 year of experience in clinical review
• Eligibility to work in the U.S. without visa or residency sponsorship