Licensed Physician Reviewer- - Otorhinolaryngology (ENT) PRN Remote

About the role

The Physician Reviewer is responsible for delegating Utilization Management (UM) cases within the organization. This includes covering specified territories, establishing 2-3 cases per day, attending health plan and local calls, and participating in PCP and SNF meetings.

Responsibilities

• Provides Delegated UM by covering the specified territories as assigned
• Ensures attendance on all health plan and local calls
• Calls in for the weekly Primary Care Provider (PCP) and Skilled Nursing Facility (SNF) meetings covering the assigned territories
• Advises other physician reviewers
• Participates in Process and Quality improvement in the area of Delegated Utilization Management

Requirements

• Graduate from accredited Medical School with a valid, unrestricted license
• Completion of Internal Medicine or Family Practice residency
• Board Certification in residency area - Otorhinolaryngology (ENT)
• 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 healthcare regulations and policies
• Ability to manage multiple tasks and prioritize effectively
• 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 arrangements
• Professional development opportunities
• Employee assistance programs
• Retirement savings plans

Join our team and make a difference in people's lives every day!