Licensed Physician Reviewer- Pulmonology - PRN - Remote
Core
Licensed Pulmonologist providing delegated Utilization Management (UM) reviews for health plan cases.
Role type
Licensed Physician Reviewer (Pulmonology)
Builds
Utilization management decisions for patient care coverage
Domain
Healthcare / Utilization Management
Deliverable
client delivery
Required skills
Pulmonology board certification, Internal Medicine or Family Practice residency, valid unrestricted medical license, analytical reasoning, problem-solving, written and verbal fluency in English
Preferred skills
Hospital medicine experience, utilization review experience
Technologies
Microsoft Office (Outlook, Excel, Word, PowerPoint)
Responsibilities
Review UM cases for assigned territories, attend health plan and local team calls, participate in weekly PCP and SNF meetings, advise other physician reviewers
Seniority
Senior, hands-on IC
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