Remote Utilization Review- Gastroenterology

Full time PRN in Health Care , in Physicians & Surgeons Email Job
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Job Detail

    Job Description

    Must Haves:
    1. ABMS Board Certified (MD or DO)
    2. Minimum of 5 years clinical experience (after fellowship)
    3. Has seen patients in last 18 to 24 months

    Tell Me About this Job:
    1. Intake- cases come in and filtered through AI then reviewed by non-clinical support
    team
    2. Nurse Review- cases then reviewed by nurse if outcome can’t be determined
    by non- clinical support team
    3. AMD Review- Cases are escalated to the AMD team if an outcome can’t be
    determined by nurse review
    4. AMD Review Process- cases are reviewed on portal or peer-to-peer calls to determine
    the appropriate evidence-based clinical decision

    AMDs (Assistant Medical Directors) will typically spend 50% of the day reviewing cases within an online portal and 50% conducting “peer-to-peer” (P2P) telephone calls. These calls are usually with the requesting provider, focusing on reconsideration of a denied case.

    Reasons to Love This Job:
    1. Work/ Life Balance- predictable work schedule, remote work opportunities, full and part- time opportunities available
    2. Continued support and hands on training
    3. Rewarding work in a highly collaborative and congenial environment
    4. Bonus eligibility

    Scheduling:
    – M-W-F schedule
    – Need to be able to have consistent schedule
    – 20 hours a week is minimum hours that can be worked
    – Cannot work less than 4 hours a day
    – 20+ hours a week (able to determine how many hours you would like to work, and
    choose schedule)

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