Prime Therapeutics

Physician Clinical Reviewer – Gastroenterology

Prime Therapeutics

part-time

Posted on:

Location Type: Remote

Location: United States

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Salary

💰 $91 - $154 per hour

About the role

  • Reviews cases for medical necessity
  • Discusses determinations with physicians
  • Provides clinical rationale for appeals
  • Assists Initial Clinical Reviewers
  • Ensures timely communication documentation
  • Participates in ongoing training
  • Assists with research related to Utilization Management

Requirements

  • DO, MBBS, or MD required
  • 5+ years of experience in clinical review
  • Eligible to work in the United States without the need for work visa
Benefits
  • Health insurance
  • Retirement plans
  • Paid time off
Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard Skills & Tools
clinical reviewmedical necessityutilization managementclinical rationaleappeals process
Soft Skills
communicationcollaborationtrainingresearch assistance
Certifications
DOMBBSMD