Physician Reviewer
Location: Saint Paul, Minnesota
Description: Prime Consultants, LLC is at the momment seeking for Physician Reviewer right now, this occupation will be depute in Minnesota. For detail informations about this occupation opportunity please read the description below.
Our client is looking for either a Pediatrician, OBGYN, Internal Medicine or Surgery Physician to do Physician Reviews. In this role you will have the opportunity to work remotely a couple days a week as well.
Description :
Responsible for the administration of medical management services for company health plans and ensures clinical integrity of broad and significant clinical programs, including the overall medical policies of the Medicare business unit.
Primary duties may include, but are not limited to:
- Evaluates requests for service coverage for medical necessity
- Interprets existing policies and develops new policies based on changes in the healthcare or medical arena.
- Leads, develops, directs and implements clinical and non-clinical activities that impact health care quality cost and outcomes.
- Supports the Medical Management staff ensuring timely and consistent responses to members and providers.
- Identifies and develops opportunities for innovation to increase effectiveness and quality.
- Serves as a resource and consultant to other areas of the company.
- May chair or serve on company committees.
- May be requ ired to represent Anthem to external entities and/or serve on external committees
MUST HAVE:
MD or DO in MN
At least 5 years of post-residency clinical experience required
Requires current, unrestricted MN license to practice medicine
Current ABMS recognized board certification required
Job Type: Full-time
License or certification:
- Unrestricted MN license to practice medicine (Required)
.
If you were eligible to this occupation, please send us your resume, with salary requirements and a resume to Prime Consultants, LLC.
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Interested on this occupation, just click on the Apply button, you will be redirected to the official website
This occupation will be opened on: Mon, 30 Apr 2018 18:01:53 GMT