Physician Reviewer

The Judge Group; Nashville (TN); Remote; USD 60,000 - 80,000; Full time

Job summary

Join a leading healthcare organization as a Physician Reviewer in a fully remote role. Utilize your clinical expertise to evaluate service requests and provide leadership in patient care management. Enjoy a supportive work environment with competitive pay and the chance to make a significant impact in healthcare.

Qualifications

• Minimum 5 years of clinical experience, including inpatient experience.
• Utilization Review experience required.

Responsibilities

• Evaluate clinical service requests from members and providers.
• Provide clinical leadership within the organization.
• Participate in the appeal process for service denials.

Skills

Clinical Judgment

Problem-Solving

Leadership

Education

Board Certified (ABMS) M.D. or D.O.

Tools

PC Proficiency

Job description

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Location: Nashville, TN

Salary: $110.00 USD Hourly - $115.00 USD Hourly

Description

Join Our Team as a Physician Reviewer (Remote) and Make a Difference!

Are you a dedicated and experienced physician looking to leverage your clinical expertise in a dynamic and impactful role? We are seeking a Physician Reviewer to join our team and contribute to our mission of providing exceptional healthcare services. This fully remote position offers flexibility and the opportunity to work from any state while making a significant impact on patient care.

Job Title : Physician Reviewer (Remote)

Location: Fully Remote - but must reside in the NASHVILLE, TN area

Job Type: Contract to hire

Required Hours

• Monday-Friday 40 hours/week
  
  

Responsibilities

• Evaluate clinical service requests from members and providers
• Utilize clinical judgment and organizational criteria to adjudicate requests
• Provide clinical leadership within the organization
• Identify opportunities to manage members' clinical situations through creative problem-solving
• Practice anticipatory case management in partnership with case managers
• Participate in the Physician Review Units' appeal process for service denials
• Contribute to the development of Physician Review Units' policies and procedures
• Actively participate in unit continuous quality improvement activities
• Perform other duties as assigned by the Medical Director
  
  

Qualifications

• Board Certified (ABMS) M.D. or D.O. required
• Unrestricted and active license to practice medicine required
• Minimum 5 years of clinical experience, including inpatient experience
• Utilization Review experience
• Understanding of managed care principles
• Demonstrated PC proficiency for computer-based file reviews
  
  

Important Note: This position does not involve direct patient care or medical diagnosis.

Why Join Us?

By joining our team, you will be part of a forward-thinking organization that values innovation, collaboration, and excellence. We offer a supportive work environment, competitive pay, and the chance to make a real difference in the lives of our members. If you are passionate about healthcare and eager to contribute your skills to a meaningful cause, we encourage you to apply!

By providing your phone number, you consent to: (1) receive automated text messages and calls from the Judge Group, Inc. and its affiliates (collectively "Judge") to such phone number regarding job opportunities, your job application, and for other related purposes. Message & data rates apply and message frequency may vary. Consistent with Judge's Privacy Policy, information obtained from your consent will not be shared with third parties for marketing/promotional purposes. Reply STOP to opt out of receiving telephone calls and text messages from Judge and HELP for help.

Contact: [e-mail]

This job and many more are available through The Judge Group. Find us on the web at www.judge.com

Seniority level

• Seniority level

  Mid-Senior level

Employment type

• Employment type

  Full-time

Job function

• Job function

  Health Care Provider

• Industries

  Hospitals and Health Care and Medical Practices

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