Physician Reviewer

Job title: Physician Reviewer
Schedule: M-F(8-5)
Contract: 2+ Years
Location: Remote (but must have Texas Medical Licensure)
Pay rate: $110Hour on W2

Description:

• Evaluates clinical service requests made by an organization's members and providers.
• Uses clinical judgment in conjunction with organization's criteria to adjudicate these requests.
• May also provide clinical leadership in other areas of the organization. Identifies opportunities to manage members' clinical situations with a view toward creative problem solving and anticipation of possible future clinical problems for the member.
• Participates in the process to evaluate clinical service requests.
• Practices anticipatory case management for members whose cases come for review, in partnership with case managers.
• Participates in the development of Physician Review Units' policies and procedures.
• Actively participates in all unit continuous quality improvement activities.
• Other duties as assigned by the Medical Director.
• Board Certified (ABMS) M.D. or D.O, unrestricted and active license to practice medicine requested and 5 years clinical experience to include inpatient experience, or any combination of education/experience that would provide an equivalent background.
• Must have understanding of managed care and

Job Types: Full-time, Contract

Pay: $100.00 - $110.00 per hour

Expected hours: 40 per week

Benefits:

• Dental insurance
• Referral program
• Vision insurance

Work Location: In person