Licensed Physician Reviewer - Neurology (remote)

Medical Care of Boston Management Corporation(2 months ago)

RemotePart TimeSenior$204,761 - $292,515Clinical Operations

About this role

The Physician Reviewer serves as the primary clinical authority for clinical appropriateness reviews across assigned markets and supports the organization’s delegated utilization management efforts. This role partners with health plans and local teams to uphold clinical quality and contribute to process and quality improvement initiatives.

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Required Skills

Clinical Review
Case Management
Utilization Review
Care Coordination
Analytical Skills
Judgment
Communication
Organization
Microsoft Office

Qualifications

Graduate From Accredited Medical School
Unrestricted Medical License
Internal Medicine Residency
Family Practice Residency
Neurology Fellowship
Board Certification In Residency Area
Board Certification In Neurology
Hospital Medicine Experience (Preferred)
Utilization Review Experience (Preferred)

About Medical Care of Boston Management Corporation

cms.gov

The Centers for Medicare & Medicaid Services (CMS) is a federal agency within the U.S. Department of Health and Human Services (HHS) that administers the nation's major healthcare programs, including Medicare and Medicaid. CMS is responsible for overseeing the healthcare system in the United States, ensuring access to high-quality healthcare services and improving health outcomes for its beneficiaries. Through its initiatives and regulations, CMS aims to provide a more transparent healthcare system and reduce costs while enhancing care delivery across the nation.

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