What are the responsibilities and job description for the Physician Reviewer position at Mitchell Martin Inc.?
Title: Physician Reviewer
Locations: TN /IL, TX, NM, OK, MT (Remote Eligible)
Employment Type: Contract to Hire
Compensation
Pay Range: $110.00-$120.00 Per HR
Description
Evaluate clinical service requests from members and providers.
Use clinical judgment with organizational criteria for adjudication.
Provide clinical leadership within the organization.
Identify opportunities for creative problem-solving in clinical situations.
Engage in anticipatory case management with case managers.
Participate in appeal processes for service denials.
Contribute to policy and procedure development for review units.
Key Responsibilities
Evaluate clinical service requests.
Use clinical judgment with established criteria.
Identify and solve potential clinical problems creatively.
Collaborate with case managers for anticipatory case management.
Participate in appeal processes for service denials.
Contribute to policy and procedure development.
Engage in continuous quality improvement activities.
Qualifications
Must have a Valid Medical State License.
Unrestricted and active license to practice medicine.
5 years of clinical experience, including inpatient experience.
Understanding of managed care.
Proficiency in using computers for file review.
Contact Information
Syed Ali, syed.ali@itmmi.com
Locations: TN /IL, TX, NM, OK, MT (Remote Eligible)
Employment Type: Contract to Hire
Compensation
Pay Range: $110.00-$120.00 Per HR
Description
Evaluate clinical service requests from members and providers.
Use clinical judgment with organizational criteria for adjudication.
Provide clinical leadership within the organization.
Identify opportunities for creative problem-solving in clinical situations.
Engage in anticipatory case management with case managers.
Participate in appeal processes for service denials.
Contribute to policy and procedure development for review units.
Key Responsibilities
Evaluate clinical service requests.
Use clinical judgment with established criteria.
Identify and solve potential clinical problems creatively.
Collaborate with case managers for anticipatory case management.
Participate in appeal processes for service denials.
Contribute to policy and procedure development.
Engage in continuous quality improvement activities.
Qualifications
Must have a Valid Medical State License.
Unrestricted and active license to practice medicine.
5 years of clinical experience, including inpatient experience.
Understanding of managed care.
Proficiency in using computers for file review.
Contact Information
Syed Ali, syed.ali@itmmi.com
Salary : $110 - $120
