Physician Clinical Reviewer - Psychiatry- REMOTE

Prime Therapeutics·Remote(United States)
Healthcare

WFA Digital Insight

The demand for skilled clinical reviewers has grown significantly in recent years, driven by the need for expert medical judgment in utilization management. With the shift to remote work, professionals with strong digital skills and clinical expertise are in high demand. Prime Therapeutics stands out for its commitment to providing high-quality healthcare services, and this role offers a unique opportunity for physicians to leverage their expertise in a remote setting. Candidates should be prepared to showcase their clinical acumen and ability to work effectively in a virtual environment.

Job Description

About the Role

As a Physician Clinical Reviewer at Prime Therapeutics, you will play a critical role in the utilization management team, providing timely medical reviews of service requests and interacting with physicians, leadership, and management staff.

Responsibilities

  • Review cases and provide medical review of service requests
  • Discuss determinations with physicians
  • Provide clinical rationale for appeals

Requirements

  • DO, MBBS, or MD degree
  • 5+ years of clinical experience
  • Eligibility to work in the US without a work visa or residency sponsorship

Benefits

  • Generous Paid Time Off
  • 401k Matching Retirement Plan
  • Tuition Reimbursement

How to Stand Out

  • Develop a strong understanding of utilization management principles and medical review guidelines to stand out in this role.
  • Showcase your ability to work effectively in a remote setting by highlighting your experience with digital communication tools and project management software.
  • Be prepared to discuss your clinical experience and expertise in psychiatry, and how you can apply this knowledge in a utilization management context.
  • Emphasize your ability to communicate complex medical information to both clinical and non-clinical stakeholders.
  • Consider highlighting any experience you have with quality improvement initiatives or peer review processes.

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