Job Description
this position is M-F 7-8 hours per day for 39 hours per week. I would also like to add that there is the potential to flex Sat/Sun as needed.
remote, but must have Texas Medical Licensure
Evaluates clinical service requests made by an organization's members and providers. Uses clinical judgment in conjunction with organization's criteria to adjudicate these requests. May also provide clinical leadership in other areas of the organization. Identifies opportunities to manage members' clinical situations with a view toward creative problem solving and anticipation of possible future clinical problems for the member. Participates in the process to evaluate clinical service requests. Practices anticipatory case management for members whose cases come for review, in partnership with case managers. Participates in the development of Physician Review Units' policies and procedures. Actively participates in all unit continuous quality improvemen...
remote, but must have Texas Medical Licensure
Evaluates clinical service requests made by an organization's members and providers. Uses clinical judgment in conjunction with organization's criteria to adjudicate these requests. May also provide clinical leadership in other areas of the organization. Identifies opportunities to manage members' clinical situations with a view toward creative problem solving and anticipation of possible future clinical problems for the member. Participates in the process to evaluate clinical service requests. Practices anticipatory case management for members whose cases come for review, in partnership with case managers. Participates in the development of Physician Review Units' policies and procedures. Actively participates in all unit continuous quality improvemen...
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