Physician Advisor – (P2P) Medical Reviewer (1099 Contractor)

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Remote - USA Remote Posted 3w ago

Position Summary The Physician Advisor (1099 Contractor) is a licensed physician responsible for conducting clinical discussions with treating providers regarding utilization management determinations. The physician applies Medicare/CMS requirements, applicable medical necessity criteria, health plan policies, and clinical judgment to determine the appropriate level of care and/or medical necessity of requested services. The role supports timely, consistent, evidence-based utilization management while providing treating physicians an opportunity to discuss relevant clinical information…

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