Physician Clinical Reviewer – Oncologist
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Job Description
Clinical Reviewer-Oncologist providing timely medical review of service requests. Interacting with physicians and staff while ensuring compliance with medical necessity guidelines.
Responsibilities:
- Reviews cases in which clinical determinations cannot be made by the Initial Clinical Reviewer
- Discusses determinations with requesting physicians
- Provides clinical rationale for standard and expedited appeals
- Utilizes medical/clinical review guidelines for consistency
- Ensures documentation of all communications is recorded
- Participates in ongoing training and testing
- Assists Medical Director in research activities/questions
Requirements:
- DO, MBBS, MD required
- 5+ years of clinical experience
- Must be eligible to work in the United States without the need for work visa or residency sponsorship.
Benefits:
- Health insurance
- 401(k) matching
- Flexible work hours
- Paid time off
- Remote work options
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