AI Summary

The 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. The candidate must be an active, board-certified cardiologist with recent patient care experience. Responsibilities include strategic planning and evaluating care management. The position offers a predictable schedule, no nights or weekends, and opportunities for growth in a supportive, collaborative culture.

AI Summary

The role involves providing expert medical review to evaluate the necessity of services, reviewing appeals for denied services, and conducting peer-to-peer discussions with physicians. Candidates must maintain credentials, participate in strategic planning, and possess a U.S. medical license with board certification in Neurology. The position offers a predictable work schedule, collaborative culture, and opportunities for growth.

AI Summary

Provide expert medical reviews to assess the necessity of services, review appeals for denied services, and engage in peer-to-peer discussions. Must be an M.D. or D.O. with board certification in Orthopedic Surgery. Maintain credentials, participate in strategic planning, and possess knowledge of relevant laws and standards.

AI Summary

This role involves providing expert medical reviews to evaluate the necessity of services, reviewing denied service appeals, and conducting peer discussions with physicians. Candidates must be board-certified in Gastroenterology with 5+ years of clinical experience. Responsibilities also include strategic planning in Care Management and ensuring credentials are maintained. A supportive environment, predictable work schedule, and opportunities for professional growth are offered.

AI Summary

Provide expert medical reviews to evaluate service necessity, handle appeals for denied services, and engage in peer-to-peer discussions with physicians. Maintain credentials and participate in strategic care management planning. Requires an M.D. or D.O. with oncology board certification and recent patient care experience.

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. The successful candidate will be an M.D. or D.O. with board certification in Oncology Radiation and a minimum of 5 years of clinical experience. Familiarity with state and federal laws, URAC and NCQA standards, and computer systems is required.

AI Summary

The role involves providing expert medical reviews to evaluate 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 Care Management strategic planning. Must be an M.D. or D.O. with board certification in Maternal-Fetal Medicine and have recent direct patient care experience. Knowledge of relevant laws and computer systems 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 physicians. Candidates must be M.D. or D.O. with current U.S. medical license, board-certified in Cardiology, and have recent patient care experience. Responsibilities also include strategic planning for Care Management.

AI Summary

The role involves providing expert medical review for evaluating the necessity of services that do not meet criteria, reviewing appeals for denied services, and conducting peer-to-peer discussions with referring physicians. The candidate must maintain medical credentials, participate in strategic planning for Care Management, and hold an M.D. or D.O. with board certification in Neurology. Familiarity with state and federal laws, URAC and NCQA standards, and computer systems is required. Enjoy a predictable work schedule with no nights or weekends in a supportive, collaborative environment.

AI Summary

The role involves providing timely 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 an M.D. or D.O. with board certification in Orthopedic Surgery and at least 5 years of clinical experience. Familiarity with state and federal laws, URAC, and NCQA standards is required.