Licensed Physician Reviewer - Neurology (remote) PRN

About the role

The Physician Reviewer is responsible for Clinical Appropriateness Reviews, advising other physician reviewers, and participating in Process and Quality improvement initiatives.

Responsibilities

• Cover the specified territories as assigned, establishing 2-3 cases per day for each market covered (up to 6 markets)
• Absentee at all health plan and local calls
• Attend weekly Primary Care Provider (PCP) and Skilled Nursing Facility (SNF) meetings covering the assigned territories
• Provide clinical guidance and support to other physician reviewers
• Participate 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
• Completion of Fellowship in Neurology
• Board Certification in residency area
• Board Certified in Neurology
• 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 judgement and problem-solving skills
• Professional and effective communication skills
• Strong organizational skills
• Written and verbal fluency in English
• Proficient in the use of Microsoft Office products such as Outlook, Excel, Word and PowerPoint

Skills

• Knowledge of clinical guidelines and standards
• Ability to interpret medical data and make informed decisions
• Strong interpersonal and collaboration skills

Benefits

We offer a competitive salary range of $204,761 - $292,515, with potential for bonuses or commissions. Employee benefits include:

• Comprehensive health insurance
• Paid time off and holidays
• Flexible work schedule
• Professional development opportunities
• Employee assistance program
• Retirement savings plan