Job Description

Title : Physician Reviewer

Locations: TN /IL, TX, NM, OK, MT (Remote Eligible)
Employment Type: Contract to Hire

Compensation:
Pay Range: $110.00-$120.00 Per HR

Description:
Evaluate clinical service requests from members and providers.
Use clinical judgment with organizational criteria for adjudication.
Provide clinical leadership within the organization.
Identify opportunities for creative problem-solving in clinical situations.
Engage in anticipatory case management with case managers.
Participate in appeal processes for service denials.
Contribute to policy and procedure development for review units.

Key Responsibilities:
Evaluate clinical service requests.
Use clinical judgment with established criteria.
Identify and solve potential clinical problems creatively.
Collaborate with case managers for anticipatory case management.
Participate in appeal processes for service denials.
Contribute to policy and procedure development.
Engage in continuous quality improvement activities.

Qualifications:
Must have a Valid Medical State License.
Unrestricted and active license to practice medicine.
5 years of clinical experience, including inpatient experience.
Understanding of managed care.
Proficiency in using computers for file review.

Contact Information:
Syed Ali, syed.ali@itmmi.com

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Job Tags

Contract work,

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