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Physician Clinical Reviewer - Interventional Pain Management
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- Physician Clinical Reviewer-Interventional Pain Management at Evolent Health in Boise, Idaho, United States Job Description Your Future Evolves Here Evolent partners with health plans and providers to achieve better outcomes for people with most complex and costly health conditions.
- 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.
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