Licensed Physician Reviewer- Neurology - 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, participating in PCP and SNF meetings, and providing guidance to other physician reviewers.

Responsibilities

• Provides Delegated UM by covering specified territories
• Ensures attendance on all health plan and local calls
• Calls in for weekly Primary Care Provider (PCP) and Skilled Nursing Facility (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 Neurology preferred
• Two (2) years’ experience in Hospital medicine preferred
• One (1) year of utilization review experience preferred

Qualifications

• Excellent analytical and deductive reasoning skills
• Good judgement 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 and prioritize effectively
• Strong interpersonal and collaboration skills

Benefits

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

Learn more about our benefits.