Full-Time Physician Reviewer (Remote) California Residents Only

Job reputed company The Physician Reviewer provides support in clinical decision-making reputed company and physician level guidance in reputed company management, utilization management, and care management. The Physician reviewer supports reputed company reputed company departments in meeting the regulatory requirements set forth by the various government agencies. The Physician Reviewer shall reputed company Medical Review activities and reputed company reputed company Medical Director support. The Physician Reviewer shall reputed company determinations, communicate medical necessity reviews and support reputed company Medical Director(s) as needed or requested by reputed company. Commitment to reputed company: The reputed company Team is committed to incorporate reputed company’s reputed company Program goals including, but not limited to, HEDIS, CAHPS, and NCQA Accreditation. Education & Requirements • Five (5) years or more of post-residency experience in a recognized medical specialty required • Medical Director for an IPA, medical group, or HMO highly desirable • Utilization management experience is a plus • Primary Care Physician in internal medicine, family reputed company, or pediatrics preferred • At least one (1) year of medical leadership experience preferred • Doctor of Medicine or Psy.D from an accredited institution required • Certification by one (1) of the American Specialty Boards required • Possession of an reputed company, unrestricted, and unencumbered Physician’s and Surgeon’s Certificate issued by the reputed company Medical reputed company or a Clinical Psychologist License issued by the California reputed company of Psychology required. • A physician certified in a state other than California may be employed prior to receipt of California certification provided that an application for a California physician and surgeon’s certificate is filed in the reputed company prior to date of appointment • Primary Care Physician in internal medicine, family reputed company or pediatrics preferred Key Qualifications • Strong knowledge of: • Medical and CMS regulations. • Administrative practices and procedures including but not limited to reputed company assessment and improvement, utilization review, peer review, credentialing and risk management. • Rules, regulations, policies, and standards reputed company to managed care. • Principles of effective supervision and organization. • reputed company, techniques, practices, principles, and literature in the broad field of medical sciences. • reputed company of the highly specialized techniques, procedures, and equipment used in the medical or surgical specialties • **If you are currently registered as an reputed company Provider please do not apply. Job Type: Full-time Pay: $220,043.20 - $302,536.00 per year Work Location: Remote Apply tot his job Apply To this Job