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
...Job Description Cure Healthcare Staffing is seeking a travel nurse RN Dialysis for a travel nursing job in Williston, North Dakota. Job Description & Requirements ~ Specialty: Dialysis ~ Discipline: RN ~ Start Date: ASAP ~ Duration: 13 weeks ~36 hours...
...Remote Digital Marketing & Client Outreach Consultant Job Type: Self-Employed | Independent Contractor | Commission-Based Location: Remote Global (region-targeted posting) ABOUT THE ROLE The Blue Shed Group is growing its digital presence and is seeking...
*Lead Teacher Needed Make an Impact!* Sandwich Childrens Center (SCC) in Center Sandwich, NH seeks full-time early childhood lead teacher for our toddler program. SCC is on a mission to become a premier child-led, nature-inspired, early childhood education center...
...CRR Hospitality is growing! Our mission is to provide unique and enjoyable places that offer accessible luxury, value, and fulfillment... ...Director of Human Resources to create effective and efficient recruitment, selection and onboarding process, filling positions in a...
...Develop a strong understanding of Company policies and procedures. Fill in, as needed, for other departments (i.e. answering phones) Required Skills/Abilities: Ability to adjust priorities and manage time wisely in a fast-paced environment. Strong communication...