Upvote
Downvote
Physician Clinical Reviewer - Interventional Pain Management
Share Job
- Suggest Revision
- What You'll Be Doing: As a Physician Clinical Reviewer, Interventional Pain Management, you will be a key member of the utilization management team.
- You can enjoy better work- life balance on a team that values collaboration and continuous learning while providing better health outcomes.
- What You Will Be Doing: Serve as the Physician Clinical Reviewer for Interventional Pain Management, reviewing cases that do not initially meet the applicable medical necessity guidelines, as well as other imaging requests when providers, clients, or state laws require specialty reviews to be completed by the subject matter expert.
- Utilizes medical/clinical review guidelines and parameters to assure consistency in the MD review process to reflect appropriate utilization and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission (URAC) and National Committee for Quality Assurance (NCQA) guidelines.
- Provides clinical rationale for standard and expedited appeals.
Active Job
Updated 2 days agoSimilar Job
Relevance
Active