Physician Clinical Reviewer – Urology
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Job Description
Clinical Reviewer for utilization management focusing on Urology. Engaging with physicians and patients to ensure adherence to clinical guidelines and rationales.
Responsibilities:
- Reviews cases in which clinical determinations cannot be made
- Discusses determinations with physicians or ordering providers
- Provides clinical rationale for standard and expedited appeals
- Participates in on-going inter-rater reliability training and testing
Requirements:
- 5+ years of experience in clinical review
- DO, MBBS, or MD 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
- Flexible work hours
- Paid time off
- Professional development opportunities
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