Clinical Policy Reviewer & Care Quality Advocate

EPITEC; Tennessee; Vor Ort; USD 150.000 - 230.000; Vollzeit

Benefits dieser Stelle

Opportunity to make a meaningful impact

Collaborative work environment

Professional development opportunities

Zusammenfassung

A healthcare organization in Tennessee is seeking a Physician Reviewer to ensure high-quality, cost-effective care for members. This role involves reviewing clinical service requests, providing expert opinions, and developing policies to enhance health outcomes. Ideal candidates should possess a Board Certified M.D. or D.O., have at least 5 years of clinical experience, and demonstrate strong analytical and communication skills. The position offers opportunities for professional growth and a collaborative work environment.

Qualifikationen

• Board Certified (ABMS) M.D. or D.O., with an active license.
• 5 years clinical experience, including inpatient experience.
• Understanding of managed care and proficiency in electronic medical records.

Aufgaben

• Review clinical service requests and provide expert opinions.
• Contribute to the development of policies and procedures.
• Work closely with the team to drive better health outcomes.

Kenntnisse

Board Certified (ABMS) M.D. or D.O., unrestricted and active license to practice medicine

5 years clinical experience

Understanding of managed care

Strong clinical judgment and analytical skills

Excellent communication and interpersonal skills

Ausbildung

Master's degree in Healthcare Administration or related field

Jobbeschreibung

A healthcare organization in Tennessee is seeking a Physician Reviewer to ensure high-quality, cost-effective care for members. This role involves reviewing clinical service requests, providing expert opinions, and developing policies to enhance health outcomes. Ideal candidates should possess a Board Certified M.D. or D.O., have at least 5 years of clinical experience, and demonstrate strong analytical and communication skills. The position offers opportunities for professional growth and a collaborative work environment.