Physician Reviewer Job at EPITEC, Chicago, IL

MHQ1bmZ1L3JCbFFqZ3lJdk41NFNHdHJsTFE9PQ==
  • EPITEC
  • Chicago, IL

Job Description

  • Location: Chicago, Illinois
  • Type: Contract
  • Job #101289
Job Title : Physician Review
Location: Remote
Job Type: Contract
Expected hours per week (must include "per week"):
40 hours per week
Schedule (include days, hours, onsite/hybrid or remote):
Monday - Friday, Remote
Pay Range (must include "per hour"):
$112 per hour
Job Description:
  • Primary Function: Evaluate clinical service requests from members and providers using clinical judgment and organizational criteria.
  • Additional Responsibilities:
    • Provide clinical leadership in other organizational areas.
    • Identify opportunities for proactive case management and creative problem-solving.
    • Collaborate with case managers for anticipatory case management.
    • Participate in:
      • Physician Review Unit's appeal process for service denials.
      • Development of policies and procedures for the Physician Review Unit.
      • Continuous quality improvement activities.
    • Perform other duties as assigned by the Medical Director.
Qualifications
  • Education & Certification:
    • Board Certified (ABMS) M.D. or D.O.
    • Active, unrestricted license to practice medicine.
  • Experience:
    • Minimum 5 years of clinical experience, including inpatient care.
    • Or equivalent combination of education and experience.
  • Skills:
    • Understanding of managed care.
    • Proficiency with PC systems (file review is computer-based).
  • Note: This position does not involve direct patient care or medical diagnosis.

#LI-JV1

Job Tags

Hourly pay, Contract work, Monday to Friday,

Similar Jobs

CyberCoders

Traveling Electrical Super - Construction Job at CyberCoders

 ...You Need for this Position 3+ years of managing electrical construction crews required Manage project field crews and ensure safety...  ...What's In It for You 100-155k (depending on experience) + Per diem 401k Health Dental Vision Life insurance Bonuses... 

FocusGroupPanel

Work At Home Data Entry Remote Admin Assistant Job at FocusGroupPanel

 ...Remote Work From Home Data Entry Clerk for Entry Level Position Work at home position for job seekers from virtually any work background who are...  .... Ditch the commute & the high gas prices No degree required Supplement your existing job. No need to quit... 

Think Together

Elementary & Middle School Tutor Job at Think Together

 ...Maintains the same high level of ethical behavior and confidentiality of information about students as is expected of fully licensed teachers. ~ Participates in in-service training sessions as assigned. Operates and cares for equipment and instructional materials.... 

Rainbow Pet Services

Dog Groomer Job at Rainbow Pet Services

 ...Competitive Compensation Fun Working Environment Interact with Pets Job Summary We are searching for an experienced Dog Groomer to join the team at our fun, creative salon. As a Dog Groomer, you will bathe and clip dogs according to breed-specific standards... 

LocumTenens.com

Anesthesiologist Needed for Locum Tenens Coverage at Facility in Philadelphia, Pennsylvania Job at LocumTenens.com

 ...anesthesiologist for locum tenens coverage involving cardiovascular cases and nerve blocks for vascular patients. The position requires part-time day shifts, typically 2 to 3 days per month, with hands-on care in an on-site operating room setting. No special certifications beyond...