To evaluate medical necessity requests for clinical services that do not meet utilization review criteria and render a clinical opinion about the medical service under review. Reviews appeals for denied services related to current relevant medical experience or knowledge in accordance with appeal policies, if so delegated. Provides timely peer-to-peer discussions with referring physicians to clarify clinical information and to explain review outcome decisions. Documents all actions related to clinical review sessions and attests to appeal review qualifications as required
- No weekends, evenings or weekends required
- 100% remote!
- Regular office hours - Monday - Friday
- Full and part time opportunities
- Board Certified in Radiation Oncology.
- Active unrestricted license to practice medicine in a state or territory the United States as a doctor of medicine or doctor of osteopathic medicine.
- Must have a minimum of five (5) years of clinical practice experience past fellowship training.
- Candidates must have recent active clinical experience in direct patient care (within the past 18 months).