Licensed Physician Reviewer- Endocrinology - PRN - Remote

About the role

The Physician Reviewer is responsible for reviewing Utilization Management (UM) cases across multiple markets. Key responsibilities include establishing 2-3 cases per day, attending health plan and local calls, and participating in process and quality improvement initiatives.

Responsibilities

• Provides Delegated UM by covering specified territories, ensuring attendance at health plan and local calls, and participating in PCP and SNF meetings.
• Advises other physician reviewers.
• Participates in Process and Quality Improvement initiatives.

Requirements

• Graduate from an accredited Medical School with a valid, unrestricted license.
• Completion of Internal Medicine or Family Practice residency.
• Board Certification in Endocrinology preferred.
• Two (2) years’ experience in Hospital medicine preferred.
• At least one (1) year of utilization review experience preferred.

Qualifications

• Excellent analytical and deductive reasoning skills.
• Good judgment and problem-solving skills.
• Professional and effective communication skills.
• Strong organizational skills.
• Written and verbal fluency in English.
• Proficient in Microsoft Office products.

Skills

• Knowledge of healthcare regulations and policies.
• Ability to manage multiple tasks simultaneously.
• Strong interpersonal and teamwork skills.

Benefits

We offer competitive compensation, comprehensive benefits, career development and advancement opportunities, and a supportive work environment that values employee well-being. Join our team and make a difference in people's lives every day.

For current employees interested in applying to our internal career site, please click here. For contingent workers, please refer to the job aid here to apply.