Job Description

One of the largest health insurers in the nation is focused on continuously building an industry-defining, world-class IT capability. Healthcare is forever evolving, especially due to emerging technologies, making this a great experience to add to your resume. Come join their winning team!

This contract role as a Remote Physician Reviewer is responsible for evaluating clinical service requests made by an organization's members and providers.

Pay Rate: $102 - $105 per hour

Responsibilities:

·Evaluate clinical service requests made by an organization's members and providers.

·Use clinical judgment in conjunction with organization's criteria to adjudicate these requests.

·Provide clinical leadership in other areas of the organization.

·Identify opportunities to manage members' clinical situations with a view toward creative problem solving and anticipation of possible future clinical problems for the member.

·P...

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