Remote Utilization Review- Gastroenterology

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