Job Description
We are excited to invite a dedicated OB/GYN Physician Reviewer to join our dynamic and growing team. As a vital member of our team, you'll contribute to improving health outcomes through your expertise and leadership.
Position Overview:
In this role, you'll provide clinical leadership and expertise for the peer review process, utilization review activities, and other areas requiring clinical consultation. Your primary responsibilities will include conducting phone consultations with hospitals across Illinois to determine medical necessity and continued stay criteria for Medicaid Fee-For-Service beneficiaries.
Note: This position is remote; however, candidates must reside within Illinois.
Key Responsibilities:
Conduct peer-to-peer consultations with physicians as needed and document these consultations.
Offer clinical expertise to support the planning and establishment of goals and policies aimed at enhancing clinical operations.
Represent our organization during state appeal processes.
Review medical information trends and assist in developing strategic plans for clinical improvements.
Participate in stakeholder engagement meetings and represent the organization effectively.
Ensure adherence to regulatory and accreditation standards.
Stay informed on relevant regulations and legislation impacting the healthcare field.
Represent and advocate for our organization at professional events and meetings as appropriate.
Qualifications:
Licensed Physician (MD/DO) with practice rights in Illinois.
Board Certification in Obstetrics and Gynecology.
Active practice experience and admitting or staff privileges at one or more Illinois hospitals or state facilities.
Experience with Medicaid programs and managing complex projects.
Proficiency in Microsoft Excel, Word, PowerPoint, Teams, and Outlook.
Strong attention to detail, organizational skills, and the ability to prioritize and execute tasks efficiently.
Ability to develop care recommendations based on clinical evaluations.
Why Join Us?
We are a team of passionate leaders, clinicians, and technologists dedicated to redefining healthcare standards. We partner with healthcare agencies, providers, and employers to enhance health outcomes nationwide. Here, you will have the opportunity to make a significant impact and advance your career with meaningful work.
Compensation:
The pay rate for this position is $125 per hour. Placement in the pay range will be determined based on factors such as experience and skill level.
How to Apply:
Thank you for considering this opportunity. Due to high application volumes, only candidates selected for further consideration will be contacted. We appreciate your interest and encourage you to apply for future openings that match your career goals.
Our organization is an Equal Opportunity Employer. All qualified applicants will be considered for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other status protected by law.
Employment Type: Full-Time
Salary: $ 125.00 Per Hour
Job Tags
Hourly pay, Full time,