Physician Clinical Reviewer – Nephrology
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Job Description
Physician Clinical Reviewer reviewing medical necessity requests for Prime Therapeutics. Collaborating with healthcare professionals to ensure compliance with treatment guidelines and policies.
Responsibilities:
- Reviews cases in which clinical determinations cannot be made
- Discusses determinations with requesting physicians
- Provides clinical rationale for standard and expedited appeals
- Participates in on-going inter-rater reliability training
Requirements:
- Education Level DO MBBS MD Required
- 5+ years Required
- Must be eligible to work in the United States without the need for work visa or residency sponsorship.
Benefits:
- Health insurance
- 401(k) matching
- Paid time off
- Professional development opportunities
- Remote work options
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