Licensed Physician Reviewer- Rheumatology - PRN (REMOTE)
Core
Licensed physician reviewer for Utilization Management (UM) cases, covering specified territories and coordinating care for patients.
Role type
Licensed Physician Reviewer (Rheumatology)
Builds
Delegated Utilization Management decisions and care coordination
Domain
Healthcare / Utilization Management
Deliverable
client delivery
Required skills
Analytical and deductive reasoning, judgement, problem-solving, written and verbal fluency in English, Microsoft Office proficiency
Preferred skills
Hospital medicine experience, Utilization review experience
Technologies
Microsoft Office (Outlook, Excel, Word, PowerPoint)
Responsibilities
Cover specified territories for Delegated UM, establish 2-3 cases daily per market, attend health plan and local calls, participate in weekly PCP and SNF meetings, advise other physician reviewers
Seniority
Mid-level, licensed specialist