Board Certified Physician

Job Summary

A company is looking for a Spine Medical Review Stream Physician.

Key Responsibilities

• Reviews medical files for utilization review, medical necessity, and appropriateness of care
• Maintains proper credentialing and state licenses while ensuring compliance with quality of care standards
• Interacts with healthcare providers to discuss cases and provides timely feedback with documented rationales

Required Qualifications

• Board certified MD or DO with a strong understanding of managed care and utilization services
• Current, unrestricted clinical license(s) with no violations of imposed restrictions
• Active medical practice required to perform appeals
• Post-graduate experience in direct patient care
• Evidence of current error and omissions liability coverage for job-related activities