Remote Physician Reviewer at The Judge Group Inc. in Boston, Massachusetts

Job Description:

Location: REMOTE

Salary: $105.00 USD Hourly - $115.00 USD Hourly

Description: Our client is currently seeking a Remote Physician Reviewer!


This is a part-time weekend opening for a 2 year contract!


Your schedule will be Sat/Sun (8am-4pm or 9am-5pm)


Must reside in IL, MT, NM, OK or TX


Equipment will be provided!


This job will have the following responsibilities:

• Evaluate clinical service requests from members and providers.


• Utilize clinical judgment and organizational criteria to adjudicate requests.


• Provide clinical leadership within the organization.


• Identify opportunities to manage members' clinical situations through creative problem-solving.


• Practice anticipatory case management in partnership with case managers.


• Participate in the Physician Review Units' appeal process for service denials.


• Contribute to the development of Physician Review Units' policies and procedures.


• Actively participate in unit continuous quality improvement activities.


• Perform other duties as assigned by the Medical Director.
  
  

Qualifications & Requirements:

• Board Certified (ABMS) M.D. or D.O. required.


• Unrestricted and active license to practice medicine required.


• Minimum 8 years of clinical experience, including inpatient experience.


• Utilization Review experience Understanding of managed care principles.


• Demonstrated PC proficiency for computer-based file reviews.

Thank you for your time!


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Contact: croche01@judge.com


This job and many more are available through The Judge Group. Find us on the web at www.judge.com Apply Now