AI Summary

The role involves providing expert medical reviews to assess the necessity of services, reviewing appeals for denied services, and engaging in peer-to-peer discussions with physicians. It requires an M.D. or D.O. with board certification in Gastroenterology, maintaining credentials, and participating in strategic care management planning. A minimum of 5 years of clinical experience and knowledge of relevant laws and standards is essential.

AI Summary

The role involves providing expert medical reviews to evaluate the necessity of services, reviewing appeals for denied services, and conducting peer-to-peer discussions with referring physicians. The candidate must be an M.D. or D.O., board certified in Oncology, with at least 5 years of clinical experience. This position requires strong knowledge of state and federal laws, URAC, and NCQA standards. The job offers a predictable schedule, no nights or weekends, and the opportunity to participate in strategic care management planning.

AI Summary

Seeking an M.D. or D.O. with board certification in Oncology Radiation to provide expert medical reviews for service necessity, handle appeals for denied services, and conduct peer-to-peer discussions with physicians. Responsibilities include maintaining credentials, strategic care management planning, and utilizing knowledge of state and federal laws. Ideal candidates have a minimum of 5 years of clinical experience and familiarity with automated processes. Enjoy a predictable schedule with no nights or weekends in a supportive, collaborative environment.

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. The successful candidate will be an M.D. or D.O. with active U.S. medical licensure and board certification in Maternal-Fetal Medicine. Responsibilities include strategic planning and maintaining credentials, with a focus on making a positive impact on healthcare.

AI Summary

This role involves providing expert medical reviews to evaluate the medical necessity of services, reviewing appeals for denied services, and engaging in peer-to-peer discussions with physicians. The candidate must maintain credentials and participate in strategic care management planning. A minimum of 5 years of clinical experience is required, alongside familiarity with state and federal laws and computer systems. The position offers a predictable work schedule, flexible opportunities, and a collaborative culture, ensuring a supportive work environment.

AI Summary

The role involves providing expert medical reviews on the necessity of services, reviewing appeals for denied services, and participating in peer-to-peer discussions with physicians. Candidates must maintain credentials, hold a U.S. medical license, and be board certified in Neurology. The position offers a predictable schedule with no nights, weekends, or on-call duties.

AI Summary

The role involves providing expert medical reviews to evaluate medical necessity, handling appeals for denied services, and engaging in peer-to-peer discussions. Candidates must be an M.D. or D.O. with a U.S. medical license, board-certified in Surgery - Orthopedics, and have at least five years of clinical experience. Responsibilities include strategic planning for care management and maintaining necessary credentials.

AI Summary

The 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 should have an active medical license and board certification in Gastroenterology, with over 5 years of clinical experience. Familiarity with state and federal laws, URAC, and NCQA standards is beneficial. The position offers a predictable schedule, no nights or weekends, and opportunities for professional growth.

AI Summary

This role involves providing expert medical reviews to assess the necessity of services, reviewing appeals for denied services, and engaging in peer-to-peer discussions with physicians. Candidates must maintain credentials and participate in strategic care management planning. An active U.S. medical license and board certification in Oncology are required, along with recent patient care experience and knowledge of relevant laws and standards.

AI Summary

This role involves providing expert medical reviews to evaluate the necessity of services, handling appeals for denied services, and engaging in peer-to-peer discussions with physicians. Requires an M.D. or D.O. with active U.S. state medical license and board certification in Oncology Radiation. Five years of clinical experience is essential. The position offers no nights, weekends, or calls, with a predictable schedule and opportunities for growth within a supportive organization.