Physician Reviewer

Mastech Digital; United States; Remote; USD 60,000 - 80,000; Part time

Job summary

An innovative firm is seeking a dedicated clinical professional to manage service requests and provide leadership in a remote capacity. This part-time position offers a competitive pay rate of $105 per hour and requires a Board Certified M.D. or D.O. with extensive clinical experience. You'll engage in critical evaluations of clinical requests, participate in quality improvement initiatives, and work closely with case managers to ensure optimal care for members. If you're looking to leverage your expertise in a flexible role that emphasizes quality assurance in healthcare, this opportunity is ideal for you.

Qualifications

• 5+ years of clinical experience, including inpatient experience.
• Understanding of managed care and proficiency in PC use.

Responsibilities

• Evaluate clinical service requests and provide clinical leadership.
• Engage in appeal processes and participate in quality improvement activities.

Skills

Clinical Judgment

Creative Problem Solving

Managed Care Understanding

PC Proficiency

Education

Board Certified M.D. or D.O.

Job description

Job Description

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This pay range is provided by Mastech Digital. Your actual pay will depend on your skills and experience — discuss with your recruiter for more details.

Base Pay Range

$105.00/hr - $105.00/hr

Position Details

• Duration: 24+ months Contract
• Location: Remote
• Work Schedule: Saturday and Sunday, 9 AM - 6 PM
• Pay Rate: $105/hour

Required Qualifications

Evaluates clinical service requests made by an organization's members and providers. Uses clinical judgment and organization's criteria to adjudicate requests. Provides clinical leadership when needed. Identifies opportunities for managing members' clinical situations with creative problem solving and future planning. Participates in evaluating clinical service requests and anticipatory case management in partnership with case managers. Engages in the Physician Review Units' appeal processes and policy development. Participates in continuous quality improvement activities. Performs other duties as assigned by the Medical Director.

Requirements include: Board Certified (ABMS) M.D. or D.O. with an active, unrestricted license to practice medicine, and at least 5 years of clinical experience, including inpatient experience. Understanding of managed care and proficiency in PC use is required. Note: This position does not involve direct patient care or medical diagnosis.

Additional Information

• Seniority Level: Director
• Employment Type: Part-time
• Job Function: Health Care Provider and Quality Assurance
• Industries: Hospitals, Healthcare, and Health and Human Services

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