Job Summary

A healthcare company is filling a position for a Telecommuting Utilization Review Physician in Hartfordrgeon in San Francisco.

Individual must be able to fulfill the following responsibilities:

• Reviewing medical files and providing recommendations
• Identifying and responding to quality assurance issues
• Identifying critiquing, and utilizing current criteria and resources

Qualifications Include:

• Attend orientation and training and meet with Physician Review Medical Director in occasion
• 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
• Current, unrestricted clinical license(s)
• Board certification by American Board of Medical specialties or American Board of Osteopathic Specialties is required
• Must be in active medical practice to perform appeals
• Post-graduate experience in direct patient care