Remote
Description: Evaluates clinical service requests made by an organization's members and providers. Uses clinical judgment in conjunction with organization's criteria to adjudicate these requests. May also provide clinical leadership in other areas of the organization. Identifies opportunities to manage members' clinical situations with a view toward creative problem solving and anticipation of possible future clinical problems for the member. Participates in the process to evaluate clinical service requests. Participates in the Physician Review Units' appeal process of service denials. Participates in the development of Physician Review Units' policies and procedures. Actively participates in all unit continuous quality improvement activities. Other duties as assigned by the Medical Director. Board Certified (ABMS) M.D. or D.O, unrestricted and active license to practice medicine requested and 5 years clinical experience to include inpatient experience, or any combination of education/experience that would provide an equivalent background. Must have understanding of managed care and demonstrate PC proficiency, as file review will be done via computer in most cases.Aya Education is seeking a dedicated Travel School Psychologist to join our team, providing vital psychological services across various educational settings. In this role, you will travel to different schools within the district to conduct evaluations, provide counseling...
...Jazz employee please apply via the Internal Career site. Jazz Pharmaceuticals is a global biopharma company whose purpose is to innovate to... ...-focused and science-driven approach powers pioneering research and development advancements across our robust pipeline of innovative...
...events! To get more info on our events, check out our summary video on YouTube: (While there subscribe!) Get involved in the esports community by joining the Carolina Games Summit as a volunteer for our collaboration with South East Game Exchange in Greenville, SC...
Primary Care Physician WellMed | Rockport, TX WellMed Medical Group is seeking a Primary Care Physician (Family Medicine or Internal Medicine) to join our established clinic in Rockport, Texas, just outside of Corpus Christi. This is an opportunity to practice in ...
...Join to save Pharmaceutical Sales Representative at RepPathFounder, RepPath Academy | Helping Career Changers & Grads Break Into Pharma, Device & Diagnostics Sales | 20+ Yrs Medical Sales Leadership PHARMACEUTICAL SALES REPRESENTATIVE OPENING - AUSTIN, TEXASWe're looking...