About this role

Serve as the Physician match reviewer in Imaging cases
Discuss determinations (peer to peer phone calls) with requesting physicians or ordering providers
Utilizes medical/clinical review guidelines and parameters to assure consistency in the MD review process
Ensures documentation of all communications with medical office staff and/or MD provider is recorded in a timely and accurate manner
May assist the Senior Medical Director in research activities/questions related to the Utilization Management process
Participates in on-going training per inter-rater reliability process.

MD/DO/MBBS
Minimum of five (5) years’ experience in the practice of Medicine, post residency
Active Clinical practice within the last 2 years is preferred
Current, unrestricted clinical license in home state medicine or required specialty
Active Board Certification by an accredited organization
Strong clinical, management, communication, and organizational skills
Energetic and curious with a passion for quality and value in health care
Computer Proficiency
Not under current exclusion or sanction by any state or federal health care program, including Medicare or Medicaid
No history of a major disciplinary or legal action by a state medical board.

Field Medical Director, Radiology

Key skills