Colorado Licensed Medical Review Physician

A company is looking for a Telecommute Medical Review Stream Physician. Key Responsibilities Review medical files and provide recommendations for utilization review and medical necessity Meet with the Medical Director to discuss quality of care and credentialing issues Maintain proper credentialing and state licenses, and return cases with clear rationales Required Qualifications Board certified MD or DO with knowledge of managed care and utilization services Current, unrestricted clinical license(s) or a process to ensure compliance with restrictions Board certification by the American Board of Medical Specialties or American Board of Osteopathic Specialties Active medical practice required for performing appeals Post-graduate experience in direct patient care

Mar 12, 2025 - 04:07

A company is looking for a Telecommute Medical Review Stream Physician. Key Responsibilities Review medical files and provide recommendations for utilization review and medical necessity Meet with the Medical Director to discuss quality of care and credentialing issues Maintain proper credentialing and state licenses, and return cases with clear rationales Required Qualifications Board certified MD or DO with knowledge of managed care and utilization services Current, unrestricted clinical license(s) or a process to ensure compliance with restrictions Board certification by the American Board of Medical Specialties or American Board of Osteopathic Specialties Active medical practice required for performing appeals Post-graduate experience in direct patient care