Physician Reviewer Job at EPITEC, Chicago, IL

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  • 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.

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Job Tags

Hourly pay, Contract work, Monday to Friday,

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