Physician Peer Reviewer – Endocrinology

This is a fully remote position, open to applicants in Pennsylvania.

📋 Description

• Accountable for the evaluation of medical case files and rendering medical judgments.

• Cases may involve medical necessity, appropriateness of medical treatments, experimental or investigational procedures, administrative or legal considerations, or a blend of these elements.

• Assesses and interprets Federal and State laws, regulations, and relevant policy guidelines.

• Finalizes and reviews the evaluation process within a specified regulatory timeframe.

⛳️ Requirements

• Successful completion of a Residency or Fellowship Program is essential.

• A current state license in a U.S. state or recognized jurisdiction as a Doctor of Medicine or Doctor of Osteopathic Medicine is required.

• The license must be unrestricted; if there are any restrictions, they must be permissible by the relevant jurisdiction.

• Must maintain a current board certification from the American Board of Medical Specialties or the American Osteopathic Association.

• At least 5 years of active clinical experience post-graduation in direct patient care.

• Experience in providing direct patient care within the last 3 years is necessary, particularly for those conducting external reviews.

🏝️ Benefits

• Accreditation in Health Utilization Management.

• Access to an elite panel of physicians.