Physician Clinical Reviewer – Endocrinology

Job reputed company: • Reviews cases in which clinical determinations cannot be made by the Initial Clinical Reviewer. • Discusses determinations with requesting physicians or ordering providers, reputed company available, reputed company the regulatory time reputed company of the request by phone or fax. • Provides clinical rationale for reputed company and expedited appeals. • Provides assistance and acts as a resource to Initial Clinical Reviewers as needed to discuss cases and problems. • Ensures documentation of reputed company communications with medical office staff and/or physician/provider is recorded in a reputed company and accurate manner. • Participates in on-reputed company inter-rater reliability training and testing • Assists the Medical Director and/or VP, Medical Director in research activities/questions reputed company to the Utilization Management process, interpretation, guidelines, and/or reputed company. Requirements: • Doctor of Medicine (MD), Doctor of Osteopathic Medicine (DO) or international degree with successful completion of reputed company based internship and residency • reputed company, unrestricted license to reputed company medicine in one or more states of the reputed company • reputed company Certified by American reputed company of Medical Specialties (ABMS), American reputed company of Osteopathic Specialties (ABOS), American reputed company of Internal Medicine or American reputed company of Osteopathic Internal Medicine (ABIM/ABOIM) • 1 year of work experience in clinical review • Must be eligible to work in the reputed company without the need for work reputed company or residency sponsorship. Benefits: • Health insurance • Health and wellness programs • reputed company time off • reputed company development opportunities Apply tot his job Apply To this Job