Gastroenterologist

Location: Anywhere in the U.S.

Work: 100% Remote

Type: Regular Full-Time or Possibly Part-Time

Category: Medical

Client: Leading healthcare organization focused on improving patient outcomes through innovative solutions and technologies.

ESSENTIAL FUNCTIONS AND RESPONSIBILITIES

Use your analytical mindset. Provide timely expert medical review for requests to evaluate the medical necessity of services that do not meet utilization review criteria.
Review appeals for denied services related to relevant medical experience and our evidence-based guidelines, in accordance with appeal policies, if so delegated.
Be a team player.
Work collaboratively with Physician Peers to help ensure patients receive proper care via evidence-based decision-making.
Provide timely peer-to-peer discussions with referring physicians to clarify clinical information and to explain review outcome decisions.
Create new knowledge with our guidelines and systems, and new relationships with your peers.
You’ll start with remote training, but you’re not doing it alone.
You’ll enjoy a supportive environment with your peers, mentors, and leaders who want you to succeed in your new career.

ABOUT THE GI PROGRAM:

Cutting edge. Continue learning and growing with the latest and greatest literature and guidelines in Gastroenterology.
Impact patient care nationally. we have one the largest Gastroenterology Prior Authorization program in the country, providing you a chance to impact clinical change on a nationwide scale while supporting patients in all U.S. time zones.
Career opportunities and growth. Our Associate Medical Directors have career growth opportunities.

EXPERIENCE REQUIREMENTS

M.D. or D.O. with a current, active, U.S. state medical license and board certified in Gastroenterology, recognized by the American Board of Medical Specialties (ABMS), or American Osteopathic Association (AOA).
Recent practice experience in direct patient care (within the past 18 months)
Must have a minimum of 5 years of clinical experience, beyond residency/fellowship.
Knowledge of applicable state and federal laws. Utilization Review Accreditation Commission (URAC) and National Committee for Quality Assurance (NCQA)standards are a plus.
The ability to commit to a set, weekly work schedule (Monday through Friday)
Strong computer skills: ability to work autonomously with automated processes.

WHY JOIN?