Job Description

One of the largest health insurers in the nation is focused on continuously building an industry-defining, world-class IT capability. Healthcare is forever evolving, especially due to emerging technologies, making this a great experience to add to your resume. Come join their winning team!

This Contract role as a Remote Physician Reviewer will be responsible for evaluating clinical service requests made by an organization's members and providers, uses clinical judgment in conjunction with organization's Utilization Management criteria to adjudicate these requests, and more (see below).

Responsibilities:

• Evaluates clinical service requests made by an organization's members and providers.
• Uses clinical judgment in conjunction with organization's Utilization Management criteria to adjudicate these requests.
• Performs peer to peer discussions.
• Actively participates in all unit continuous quality improvement activities.
• Other duties as assigned by the Medical Director.

Requirements :

• Board Certified (ABMS) M.D. or D.O, unrestricted and active license to practice medicine requested and 5 years clinical experience to include inpatient experience, or any combination of education/experience that would provide an equivalent background.
• Must have understanding of managed care and demonstrate PC proficiency, as file review will be done via computer in most cases. (Note: Position does not provide direct patient care or medical diagnosis.)
• Must be licensed in TX

Pay Rate: $115 - $130 / hour

Benefits : 

Solving IT, a Woman and LGBTQ+ owned and operated organization is thrilled to provide a comprehensive benefit package to all our W2 employees and their families, regardless of gender. We are proud to offer five diverse health plan options as well as a PPO dental plan through Blue Cross Blue Shield, Term Life/AD&D Insurance, and a 401(k) Savings Plan. Solving IT covers a portion of the health and dental premiums for our employees. 

As you progress in your professional journey, Solving IT is dedicated to accommodating your evolving preferences and matching you with fulfilling projects. We champion equality and embrace diversity in all its forms. Creating an atmosphere that encourages varied perspectives to collaborate fosters personal development, strengthens team unity, and contributes to the overall success of the organization! 

Whether you're seeking your next career challenge or aiming to stay abreast of industry trends, Solving IT is committed to supporting your career advancement. We actively encourage applications from all backgrounds and utilize the most up-to-date market insights and compensation data to ensure that you receive not just advice, but the complete Solving IT Experience. 

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