Physician Reviewer

EPITEC; United States; Remote; USD 200,000 - 225,000; Full time

Benefits offered by this job

Fully remote work arrangement

Opportunity for professional development

Collaborative work environment

Job summary

A leading healthcare organization seeks a Physician Reviewer to ensure high-quality, cost-effective care for members. This fully remote role involves reviewing clinical service requests, providing expert opinions, and developing relevant policies. Candidates must be board certified with significant clinical experience and strong analytical skills.

Qualifications

• 5 years clinical experience, including inpatient experience.
• Understanding of managed care.
• Ability to work independently and as part of a team.

Responsibilities

• Review clinical service requests and provide expert opinions.
• Develop policies and procedures aligned with organizational criteria.
• Identify opportunities for creative problem-solving.

Skills

Clinical judgment

Analytical skills

Communication

Interpersonal skills

Education

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

Master's degree in Healthcare Administration or related field

Tools

PC (electronic medical records)

Job description

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Direct message the job poster from EPITEC

As a Physician Reviewer, you'll play a critical role in ensuring that our members receive high-quality, cost-effective care. You'll work closely with our team to review clinical service requests, provide expert opinions, and develop policies and procedures that align with our organization's criteria. Your expertise will help us identify opportunities for creative problem-solving and anticipation of future clinical problems, ultimately driving better health outcomes for our members.

Required Skills

• Board Certified (ABMS) M.D. or D.O, unrestricted and active license to practice medicine
• 5 years clinical experience, including inpatient experience, or equivalent education and experience
• Understanding of managed care and proficiency in PC (electronic medical records)
• Strong clinical judgment and analytical skills
• Excellent communication and interpersonal skills

Nice to Have Skills

• 10 years clinical experience
• Experience with managed care and utilization management
• Strong leadership and management skills

Preferred Education and Experience

• Master's degree in Healthcare Administration, Public Health, or related field (optional)

Other Requirements

• Ability to work independently and as part of a team
• Strong organizational and time management skills
• Ability to maintain confidentiality and handle sensitive information
• Willingness to participate in continuous quality improvement activities

What We Offer

• Fully remote work arrangement (Weekends only) 9AM to 6PM CST
• Opportunity to make a meaningful impact in the lives of our members
• Collaborative and dynamic work environment
• Professional development and growth opportunities

Seniority level

• Seniority level

  Associate

Employment type

• Employment type

  Full-time

Job function

• Job function

  Health Care Provider

• Industries

  Hospitals and Health Care

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Inferred from the description for this job

401(k)

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