Develop, maintain and assure compliance with physician review policies and procedures. Support collaborative relationships with physicians. Required Skills: Travel: Yes, 10 % of the Time. Board Certified in an approved ABMS Medical Specialty. MD or DO degree.
Assessing the participant, and working with the participant, family and physician to identify problems. Providing utilization review/pre-certification or pre-notifications on various individuals. Assessing and documenting clinical and behavioral outcomes.