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Reposted YesterdaySaved
In-Office or Remote
Home, PA, USA
91K-154K Hourly
Senior level
91K-154K Hourly
Senior level
Insurance
The Physician Clinical Reviewer assesses and reviews medical service requests, collaborates with physicians, and ensures compliance with medical guidelines.
Reposted YesterdaySaved
In-Office or Remote
Home, PA, USA
91K-154K Hourly
Mid level
91K-154K Hourly
Mid level
Insurance
The Physician Clinical Reviewer conducts medical reviews of service requests, interacts with healthcare providers, and ensures compliance with medical guidelines.
Top Skills: Clinical ReviewMedical Necessity GuidelinesUtilization Management
Reposted YesterdaySaved
In-Office or Remote
Home, PA, USA
91K-154K Hourly
Senior level
91K-154K Hourly
Senior level
Insurance
The Physician Clinical Reviewer-Oncologist provides medical reviews of service requests, interacts with physicians, and assists with utilization management processes.
Reposted YesterdaySaved
In-Office or Remote
Home, PA, USA
91K-154K Hourly
Senior level
91K-154K Hourly
Senior level
Insurance
The Physician Clinical Reviewer evaluates medical necessity for service requests, collaborates with healthcare providers, ensures compliance with guidelines, and assists in training and research activities.
Reposted YesterdaySaved
In-Office or Remote
Home, PA, USA
91K-154K Hourly
Senior level
91K-154K Hourly
Senior level
Insurance
The Physician Clinical Reviewer conducts medical reviews, interacts with healthcare providers, ensures compliance with guidelines, and assists in utilization management decisions.
Top Skills: Clinical Review ProcessesMedical Review GuidelinesNcqa GuidelinesUrac
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Reposted YesterdaySaved
In-Office or Remote
Home, PA, USA
91K-154K Hourly
Senior level
91K-154K Hourly
Senior level
Insurance
The Physician Clinical Reviewer evaluates medical service requests, discusses cases with providers, ensures compliance with guidelines, and documents communication accurately.
Top Skills: Medical Review GuidelinesNcqaUrac
Reposted YesterdaySaved
In-Office or Remote
Home, PA, USA
91K-154K Hourly
Senior level
91K-154K Hourly
Senior level
Insurance
The Physician Clinical Reviewer evaluates service requests for medical necessity, interacts with physicians, provides clinical rationale for appeals, and ensures compliance with guidelines.
Reposted 3 Days AgoSaved
In-Office or Remote
Home, PA, USA
91K-154K Hourly
Expert/Leader
91K-154K Hourly
Expert/Leader
Insurance
The Physician Clinical Reviewer evaluates service requests for medical necessity, collaborating with physicians and medical staff, providing rationale for appeals, and ensuring compliance with guidelines.
Reposted 4 Days AgoSaved
In-Office or Remote
Home, PA, USA
74K-118K Annually
Senior level
74K-118K Annually
Senior level
Insurance
The Pharmacy Network Consultant is responsible for managing and developing pharmacy networks, negotiating contracts, conducting audits, and ensuring compliance with policies. They analyze network performance and maintain relationships with pharmacy providers.
Reposted 4 Days AgoSaved
In-Office or Remote
Home, PA, USA
74K-118K Annually
Senior level
74K-118K Annually
Senior level
Insurance
The Pharmacy Network Consultant Sr manages pharmacy networks, negotiates agreements, ensures compliance, conducts audits, and develops relationships with pharmacy providers.
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