State Licensed Physician Reviewer
A company is looking for a Remote Physician Reviewer to leverage clinical expertise in a dynamic role. Key Responsibilities Evaluate clinical service requests from members and providers Utilize clinical judgment to adjudicate requests and provide clinical leadership Participate in the appeal process for service denials and contribute to policy development Required Qualifications Board Certified (ABMS) M.D. or D.O. required Unrestricted and active license to practice medicine required Minimum 7 years of clinical experience, including inpatient experience Utilization Review experience Understanding of managed care principles
A company is looking for a Remote Physician Reviewer to leverage clinical expertise in a dynamic role.
Key Responsibilities
Evaluate clinical service requests from members and providers
Utilize clinical judgment to adjudicate requests and provide clinical leadership
Participate in the appeal process for service denials and contribute to policy development
Required Qualifications
Board Certified (ABMS) M.D. or D.O. required
Unrestricted and active license to practice medicine required
Minimum 7 years of clinical experience, including inpatient experience
Utilization Review experience
Understanding of managed care principles
