Position: Physician Reviewer Location: Remote in Texas (must have Texas Medical Licensure) Schedule: M-F 7-8 hours per day for 39 hours per week. Flex Sat/Sun as needed. Pay: $110 per hour Job Description: The physicianreviewer evaluates clinical service requests based on company guidelines to make medical necessity determinations. May also provide clinical leadership in other areas of the organization. Identifies opportunities to manage members' clinical situations with a view toward creative problem solving and anticipation of possible future clinical problems for the member. Participates in the process to evaluate clinical service requests. Practices anticipatory case management for members whose cases come for review, in partnership with case managers. Participates in the development of Physician Review Units' policies and procedures. Actively participates in all unit continuous quality improvement activities. Other duties as assigned by the Medical Director. Required Education/Skills: Must be Board Certified, M.D. or D.O with an unrestricted physician license in Texas. Must demonstrate PC proficiency, as file review will be done via computer in most cases. 5 years clinical experience to include inpatient experience, or any combination of education/experience that would provide an equivalent background. (Note: Position does not provide direct patient care or medical diagnosis.) #J-18808-Ljbffr EPITEC
South Carolina Spine Center Scspinecenter.org Greenwood is a picturesque town situated in the foothills of South Carolina and on the shores of Lake Greenwood. It is a three-hour drive to Charlestons beautiful beaches, two hours to the Appalachian Mountains, and equivalent...
Description Summary: The Licensed Practical assists the Registered Nurse in the delivery of patient care. Under the supervision of the Registered Nurse, the LPN is responsible for administering direct patient care, treatments as ordered by the physician and administering...
THE ROLE ProbablyMonsters is seeking a Senior Sound Designer with a Mix focus. In this role you will play an active role supporting the audio and marketing teams with in-game and linear mixes. As a Senior Sound Designer with a Mix focus , you will be responsible for our...
Join Our Team as a Work-From-Home Data Entry Research Panelist! Are you ready to earn money from the comfort of your own home? This exciting opportunity is perfect for anyone with a variety of skills and backgrounds whether youve been an administrative...
Clinical Documentation Improvement Specialist (Finance)Clinical Documentation Improvement Specialist (Finance)Riverside University Health System-Medical... ...- Saturday, 9/80 work schedule, and offer a hybrid remote schedule, one day per week in the office (during training...