Physician Reviewer Job at EPITEC, Richardson, TX

emlocmhBY0hWUHJ5b0dkZVhSSkRudm1rQnc9PQ==
  • EPITEC
  • Richardson, TX

Job Description

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 Tags

Hourly pay, Flexible hours,

Similar Jobs

Roper St. Francis Healthcare - 316 Calhoun Street

Travel Hospice Registered Nurse - $2,130 per week Job at Roper St. Francis Healthcare - 316 Calhoun Street

 ...Carolina RN License Job Details Provide nursing care for patients following established...  ..., symptom assessment and management, education/teaching, and end-of-life care....  ...diseases. Exposure to toxic substances, pharmaceutical preparations, hazardous and unsafe... 

Otsuka Pharmaceutical

Senior Director, CNS Communications Job at Otsuka Pharmaceutical

 ...Job Summary The Senior Director, CNS Communications, is the senior strategic communications lead for all external and internal communications...  ...communications advisor to leaders in Commercial and Brand, Medical Affairs, Clinical Development and Portfolio Strategy... 

Mastech Digital

Database Developer/ETL Job at Mastech Digital

 ...technology staff as well as Digital Transformation Services for all American Corporations. We are currently seeking a Database Developer/ETL for our client in the Financial Services domain. We value our professionals, providing comprehensive benefits and the... 

Airbus Americas, Inc.

HR Shared Services Specialist Job at Airbus Americas, Inc.

 ...administrative process for all personnel actions for employees, temps and interns.* Acts as a liaison and clearing house for data and...  ...and offboarding process of employees and facilitate new hire orientations as required.* Provide initial communication and response... 

Piedmont HealthCare

Gastroenterology Physician Assistant Job at Piedmont HealthCare

 ...APP - Gastroenterology Outpatient JOB PURPOSE: Performs a variety of patient care activities...  ...management. Works in conjunction with physicians to provide medical services to patients...  ...and therapeutic procedures to assist in diagnosing medical and surgical problems...