Apply now and our proprietary system will quickly have you in front of a live recruiter. The Opportunity Description We're looking for a Physician Reviewer M.D. or D.O., working in Healthcare Systems and Services industry in 300 E. Randolph Street , Chicago, Illinois, 60601, United States. Evaluates clinical service requests made by an organization's members and providers. Uses clinical judgment in conjunction with organization's criteria to adjudicate these requests. Provides clinical leadership in other areas of the organization. Identifies opportunities to manage members' clinical situations with a view toward creative problem solving and anticipation of possible future clinical problems for the member. Participates in the process to evaluate clinical service requests. Practices anticipatory case management for members whose cases come for review, in partnership with case managers. Participates in the Physician Review Units' appeal process of service denials. Participates in the development of Physician Review Units' policies and procedures. Actively participates in all unit continuous quality improvement activities. Our ClientOur client is a fast-growing industry-recognized staffing firm. Recruiting critical IT, Financial, Engineering, Healthcare, and Data Analytics talent. With 20+ years' experience and growth. Connections in Automotive, Healthcare, Retail, Financial & Insurance, and Professional & Business Services. Working to bring top talent together with premier organizations. Big enough to have great opportunities. Small enough to care about finding the right one for you. It'sabout relationships based on mutual interest. The results are low turnover, long-lasting partnerships and growth. Want to work for a company invested in your success?Experience Required for Your Success Board Certified (ABMS) M.D. or D.O, unrestricted and active license to practice medicine requested 5 years clinical experience to include inpatient experience, or any combination of education/experience that would provide an equivalent background Understanding of managed care and demonstrate PC proficiency, as file review will be done via computer in most cases REMOTE weekend work - at least 2 weekends per monthWhat Do You Think?Does your experience reflect what it takes to be successful in this role? Do the work and challenges get you excited about what's possible?
PSG Global Solutions Careers...We are currently seeking a dedicated and experienced RN Clinical Documentation Improvement Specialist with a Registered Nurse (RN) background to enhance these clinical documentation practices, ensuring the highest levels of patient care and compliance with healthcare...
Join Our Advisory Board at Woodpecker Court!Are you passionate about education and strategic leadership? Do you have the skills to help... ...educational needs and disabilities (SEND).As an Advisory Board Member, you will play a crucial role similar to that of a school...
...Work from Home Office, Data Entry Remote Part-Time/Full-time Job About the Job Position: This remote entry-level role comes with... .... * Proficiency in fundamental computer applications and typing, encompassing email correspondence and data input. * Capacity...
...Description Introduction Do you want to join an organization that invests in you as a(an) Monitor Tech? At HCA Florida JFK North Hospital, you come first. HCA Healthcare has committed up to $300 million in programs to support our incredible team members over the...
...Fund Accountant NYC Private Credit - Investment Management Firm J Harlan Group is currently conducting a search for an experienced and highly motivated Fund... ...to experience at a private credit, private equity, hedge fund manager, fund administrator or public...