Physician Reviewer

Overview:

• Pre-service reviews only.
• Training will be for 3-4 days per week for at least 4 weeks, Monday - Friday 8a-5pm [CST].
• Seeking physician medical reviewer for REMOTE weekend work - at least 2 weekends per month.

Role Scope & Responsibilities:

• Support areas: Utilization Management (UM) and Pre-Services.
• Not a Private Duty Nurse role.
• Covers a broad range of cases across specialties.
• to do atleast 32 cases per weekend.

Clinical Specialty Background:

• Experience across:
  • Family Practice (FPs).
  • Internists.
  • Hospitalists.
  • General SME-type background.
• Ability to cross-cover multiple specialties and case types.

Experience & Licensing Requirements:

• Minimum 5 years of experience required.
• Active MD/ DO license in any U.S. state is acceptable.
• This position requires an initial time commitment of at least 4 weeks to undergo and complete training.
• After training, physician medical reviewer will provide weekend coverage, 8-hour shifts per Saturday and/or Sunday per month.
• Goal productivity of at least 32 cases per weekend day.
• This is a remote position.
• Physician medical reviewer evaluates clinical service requests based on company guidelines to make medical necessity determinations.
• Must be board Certified, M.D. or D.O with an unrestricted physician license in a state or territory of the United States.
• Must demonstrate basic computer skills.
• (Note: Position does not provide direct patient care or diagnostic evaluation).

Scheduling Expectations:

• Minimum commitment of at least 2 weekends per month.
• Opportunity to work additional weekday hours, subject to availability and hiring manager approval.
• Flexible weekend selection available.

Training Details:

• Training will be conducted on weekdays (Monday–Wednesday).
• Duration: 4 weeks.