Physician Reviewer

4 weeks ago


New York, New York, United States w3r Consulting Full time
Job Summary

We are seeking a highly skilled Physician Reviewer to join our team at w3r Consulting.

The successful candidate will be responsible for evaluating clinical service requests made by our organization's members and providers.

Using clinical judgment in conjunction with our Utilization Management criteria, the Physician Reviewer will adjudicate these requests and perform peer-to-peer discussions.

Additionally, the candidate will actively participate in all unit continuous quality improvement activities.

Other duties may be assigned by the Medical Director.

The ideal candidate will be a Board Certified (ABMS) M.D. or D.O. with an unrestricted and active license to practice medicine and at least 5 years of clinical experience, including inpatient experience.

A strong understanding of managed care and proficiency in PC software is also required, as file review will be done via computer in most cases.

Please note that this position does not provide direct patient care or medical diagnosis.


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