Physician Reviewer | Remote | Contract to Hire Position Available In Davidson, Tennessee
Tallo's Job Summary: Walker Healthforce is seeking a Physician Reviewer for a healthcare client located remotely. This is a contract position where the Physician Reviewer will review and evaluate clinical service requests, participate in case management, and support the appeal process. Requirements include being Board Certified, having 5 years of clinical experience, and strong analytical skills. Contact Walker Healthforce for more information.
Job Description
Physician Reviewer | Remote | Contract to Hire
Business & Care Management Nashville, Tennessee
Contract-to-Hire
Apr 3, 2025
Physician Reviewer | Remote | Contract to Hire Walker Healthforce is seeking a Physician Reviewer for a healthcare client located remotely. This is a contract position.
START DATE
ASAP Walker Healthforce Standard Perks:
Weekly pay via Direct Deposit
Medical, Dental, and Vision Available 401K
JOB DESCRIPTION
Review and evaluate clinical service requests to determine medical necessity in accordance with organizational criteria.
Apply clinical expertise to adjudicate requests effectively and accurately.
Participate in anticipatory case management in collaboration with case managers to identify and mitigate potential care issues.
Support the Physician Review Unit’s appeal process, including service denial reviews.
Identify opportunities for improved management of members’ care, using proactive, creative problem-solving strategies.
Assist in developing and refining policies, procedures, and guidelines for the unit.
Engage in continuous quality improvement (CQI) initiatives.
Provide leadership and insight in cross-functional clinical discussions or organizational projects as needed.
Perform other duties as assigned by the Medical Director.
JOB REQUIREMENTS
Board Certified (ABMS) M.D. or D.O, unrestricted and active license to practice medicine
5 years clinical experience to include inpatient experience
Strong understanding of managed care concepts and utilization review.
Proficiency with computer systems; file reviews are primarily conducted electronically.
Excellent analytical, communication, and collaboration skills. Contact our Recruiting Team today to experience the Walker Healthforce difference!
ABOUT US
Walker Healthforce is known as the dominant force of performance, precision, expertise, and integrity in the healthcare consulting community! As a certified WMBE, we provide end-to-end healthcare IT and clinical solutions to hospitals, health systems, and payer organizations, including Fortune 100 firms nationwide. We are healthcare experts, we’re custom not commodity and we’ve been exceeding expectations for nearly 20 years. Join forces with us to experience unparalleled results today! We are an Equal Opportunity Employer committed to a culturally diverse workforce. All qualified applicants will receive consideration for employment without regard to race, religion, color, age, sex, national origin, sexual orientation, gender identity, disability status or protected veteran status. #IND2
