AI Summary

The role involves providing expert medical review to evaluate the necessity of services, reviewing appeals for denied services, and engaging in peer-to-peer discussions with physicians. The ideal candidate will have a current U.S. medical license, board certification in Maternal-Fetal Medicine, and a minimum of 5 years of clinical experience. Responsibilities include maintaining credentials and participating in strategic planning for Care Management. This is a no-call, predictable schedule position with full and part-time opportunities.

AI Summary

Provide expert medical reviews to assess the necessity of services, handle appeals, and conduct peer-to-peer discussions with physicians. Maintain credentials and participate in strategic planning. Requires M.D. or D.O., board certification in Cardiology, and 5+ years clinical experience.

AI Summary

The role involves providing expert medical reviews for service requests, evaluating medical necessity, reviewing appeals, and conducting peer-to-peer discussions with physicians. Candidates must maintain credentials and have board certification in Neurology, with recent patient care experience.

AI Summary

Provide expert medical review to evaluate the necessity of services, manage appeals, and conduct peer-to-peer discussions with physicians. Participate in strategic planning and maintain credentials. Requires M.D. or D.O., board certification, and recent clinical experience.

AI Summary

The role involves providing expert medical reviews to evaluate service necessity, reviewing appeals for denied services, and conducting peer-to-peer discussions with physicians. Candidates must be board-certified in Gastroenterology, have recent direct patient care experience, and maintain necessary credentials.

AI Summary

This role involves providing expert medical reviews to evaluate the necessity of services, reviewing appeals for denied services, and conducting peer-to-peer discussions with physicians. Candidates must be board-certified in Oncology, maintain necessary credentials, and have over five years of clinical experience. Responsibilities include participating in strategic planning and understanding state and federal laws, URAC, and NCQA standards.

AI Summary

The role involves providing expert medical reviews to determine the necessity of services, reviewing appeals for denied services, and conducting peer-to-peer discussions with physicians. The candidate must be a board-certified M.D. or D.O. with recent patient care experience. Responsibilities also include participating in strategic planning and maintaining credentials. The position offers a predictable schedule, no nights or weekends, and a supportive environment with opportunities for growth.

AI Summary

The role involves providing expert medical reviews for evaluating service necessity, reviewing appeals for denied services, and conducting peer-to-peer discussions with physicians. Candidates must hold an M.D. or D.O., be board certified in Maternal-Fetal Medicine, and have a minimum of 5 years of clinical experience. The position offers a predictable schedule, no nights or weekends, and opportunities for professional growth in a supportive, collaborative environment.

AI Summary

The role involves providing expert medical reviews for service requests, evaluating medical necessity, and reviewing appeals for denied services. Responsibilities include peer-to-peer discussions with physicians, maintaining credentials, and participating in strategic care management planning. Candidates must be M.D. or D.O., board-certified in Cardiology, with 5+ years of clinical experience. Knowledge of laws and standards is beneficial. This salaried position offers a supportive, collaborative culture with flexible scheduling and growth opportunities.

AI Summary

This role involves providing expert medical reviews for service requests, reviewing appeals, and engaging in peer-to-peer discussions with physicians to clarify clinical information. The candidate must be a board-certified M.D. or D.O. in Neurology with recent practice experience. Responsibilities include strategic planning for Care Management and maintaining necessary credentials. The position offers predictable work schedules, no night or weekend shifts, and opportunities for professional growth within a supportive and collaborative organization.