New Jersey Licensed PM&R Physician

A company is looking for a PM&R Telecommute Medical Review Stream physician. Key Responsibilities Review medical files and provide recommendations for utilization review, medical necessity, and appropriateness of care Maintain proper credentialing and state licenses while returning cases with clear rationales in a timely manner Identify and utilize current criteria and resources to support objective decision-making in reviews Required Qualifications, Training, and Education Board certified MD or DO with a strong understanding of managed care and quality assurance Current, unrestricted clinical license(s) or a process in place to ensure compliance with restrictions Board certification by relevant medical specialties is required Active medical practice is necessary to perform appeals Post-graduate experience in direct patient care is required

Mar 12, 2025 - 01:35

A company is looking for a PM&R Telecommute Medical Review Stream physician. Key Responsibilities Review medical files and provide recommendations for utilization review, medical necessity, and appropriateness of care Maintain proper credentialing and state licenses while returning cases with clear rationales in a timely manner Identify and utilize current criteria and resources to support objective decision-making in reviews Required Qualifications, Training, and Education Board certified MD or DO with a strong understanding of managed care and quality assurance Current, unrestricted clinical license(s) or a process in place to ensure compliance with restrictions Board certification by relevant medical specialties is required Active medical practice is necessary to perform appeals Post-graduate experience in direct patient care is required