Must be able to: Provide physician review services for utilization management, case management, and quality management. Develop maintain and assure compliance with physician review policies and procedures for utilization management.
A healthcare company has a current position open for a Telecommute Orthopedic Surgery Utilization Review Physician in San Antonio. Core Responsibilities of this position include: Reviewing medical files and provides recommendations for utilization review.
A healthcare company is filling a position for a Telecommute Multi Specialty Utilization Review Physician in Stamford. Core Responsibilities Include: Reviewing medical files and providing recommendations for utilization review.
Supporting physician decision-making. Position Requirements Include: Bachelor’s degree in a relevant field, or an equivalent combination of education and highly relevant experience. Current, unrestricted license as an LPN or RN. Previous experience in Managed Care, Utilization Management.
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.
Communicating, coordinating, and interviewing physician members. Required Skills: Must be within commuting distance of office located on the Red Line in NW DC to attend periodic team meetings. 4-year degree. Some proven experience in project management.
Must be a licensed physician. Experience using computerized systems. Significant clinical trial experience. Experience writing clinical study reports, poster presentations, and manuscripts for publication in a scientific journal.
Core Responsibilities of this position include: Directing the development of training materials for nurses and physicians. Overseeing and review medical necessity determinations to ensure the consistency. Supervising, scheduling and managing internal physician team members. Required Skills:
Provide oversight and/or assist with benefit determinations. Monitor IRO and physician advisor timeliness and provide reminder communication as needed. Coordinate with the appeals team on the retrospective review process. Required Skills:
A healthcare company is in need of a Telecommute Occupational Medicine Utilization Review Physician in San Antonio. Individual must be able to fulfill the following responsibilities: Reviewing medical files and provides recommendations for utilization review.