Physician Reviewer
22 hours ago
We are seeking a highly skilled Physician Reviewer to join our team at Doctors Choice Placement Services, Inc. As a Physician Reviewer, you will play a critical role in ensuring the medical appropriateness of services by reviewing clinical information and applying evidence-based guidelines.
About the OpportunityThis is a fast-paced environment that favors individuals who are able to learn quickly, be hands-on, handle ambiguity, and communicate effectively with people of different backgrounds and perspectives.
Responsibilities- Provide timely medical reviews that meet our stringent quality parameters
- Provide clinical determinations based on evidence-based criteria while utilizing clinical acumen
- Clearly and accurately document all communication and decision-making in workflow tools, ensuring a member and provider can easily reference and understand your decision
- Meet the appropriate turn-around times for clinical reviews
- Conduct timely peer-to-peer discussions with treating providers to clarify clinical information and to explain review outcome decisions, including feedback on alternate treatment based on medical necessity criteria and evidence-based research
To be successful in this role, you will need:
- Completed US-based residency/fellowship program in Orthopedic Surgery, Neurosurgery, Pain Management, or Primary Care Sports Medicine
- Board certification as an MD or DO with a current unrestricted state license to practice medicine
- 5+ years of clinical practice beyond residency/fellowship in Orthopedic Surgery, Neurosurgery, Pain Management, or Primary Care Sports Medicine
We also welcome applicants with:
- 1+ years of managed care utilization review experience
- Membership in national and/or regional specialty societies
Doctors Choice Placement Services, Inc. is a rapidly scaling company that is committed to illuminating healthcare for patients, their doctors, and all those who are important in a patient's healthcare experience. We build software that ensures the appropriate plan of care is understood and expeditiously approved, so that patients and doctors can focus on health, rather than payment or administrative hassles.
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