Licensed Physician Reviewer - Nephrologist
Remote · from United States
Core
Primary physician reviewer for Utilization Management (UM) cases, covering specified territories and coordinating care for patients.
Role type
Licensed Physician Reviewer (Nephrologist)
Builds
Delegated Utilization Management decisions for health plans and local teams
Domain
Healthcare / Utilization Management
Required skills
Medical School graduate, valid unrestricted medical license, Internal Medicine or Family Practice residency, Board Certification
Preferred skills
Hospital medicine experience, Utilization review experience
Technologies
Microsoft Office (Outlook, Excel, Word, PowerPoint)
Responsibilities
Establish 2-3 UM cases daily per market, attend health plan and local calls, participate in weekly PCP and SNF meetings, advise other physician reviewers
Seniority
Mid-level, specialized clinical role