Job Title- Physician Reviewer
Duration: 6 Months contract to hire
Mode: Remote, this position is full-time Monday-Friday
Candidate must reside in Illinois, Montana, New Mexico, Oklahoma or Texas.
Rate: $120/Hour
Salary:$250k/Annum
Required Qualifications:
Evaluates clinical service requests made by an organization's members and providers. Uses clinical judgment in conjunction with organization's criteria to adjudicate these requests. 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 Physician Review Units' appeal process of service denials. 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. Board Certified (ABMS) M.D. or D.O, unrestricted and active license to practice medicine requested and 5 years clinical experience to include inpatient experience, or any combination of education/experience that would provide an equivalent background. Must have understanding of managed care and demonstrate PC proficiency, as file review will be done via computer in most cases. (Note: Position does not provide direct patient care or medical diagnosis.)
...Get Paid, Have Fun, Make a Difference!~Located in Moncure , near Pittsboro . ~Summer and year-round opportunities. ~Counselors assist campers in all aspects of self-care (dressing, bathing, eating, grooming, toileting) and other areas of daily living. ~Implement...
Office Depot Office Max , Delivery Driver , Class BDenver, COLORADO , Pay: 16.50Please apply at http://jobs.officedepot.com/job/6996673/delivery-driver-denver-co/Responsibilities:The Delivery Specialist (Driver)is responsible for delivering customer orders in a ...
...We are seeking a Construction Project Engineer to join our team in San Antonio, TX. This role is ideal for a candidate with industrial construction project experience who is looking to advance their career in a dynamic and fast-paced environment. You will support...
...for a CDL Class B driver responsible for operating bulk trucks and installing blasting products at construction sites, mines, and quarries while maintaining equipment. The position involves a blend of driving (40%) and physical labor (60%) under various weather conditions...
Pet sitter, this Friday th Sunday in home , and also at the end of month , possible 3 to 5days Small dog ,Please visit to view full details and to apply. Lots of jobs to choose from!