Sorry, this job is no longer accepting applications. See below for more jobs that match what you’re looking for!

Remote Utilization Review- General Surgeon

Expired Job

Healthcare Recruiters Dallas , TX 75201

Posted 2 months ago

Must Haves:

1. ABMS Board Certified (MD or DO)

2. Minimum of 5 years clinical experience (after fellowship)

3. Has seen patients in last 18 to 24 months

Tell Me About this Job:

1. Intake- cases come in and filtered through AI then reviewed by non-clinical support team

2. Nurse Review- cases then reviewed by nurse if outcome can't be determined by non- clinical support team

3. AMD Review- Cases are escalated to the AMD team if an outcome can't be determined by nurse review

4. AMD Review Process- cases are reviewed on portal or peer-to-peer calls to determine the appropriate evidence-based clinical decisionAMDs (Assistant Medical Directors) will typically spend 50% of the day reviewing cases within an online portal and 50% conducting peer-to-peer (P2P) telephone calls. These calls are usually with the requesting provider, focusing on reconsideration of a denied case.

Reasons to
Love This Job:

1. Work/ Life Balance- predictable work schedule, remote work opportunities, full and part- time opportunities available

2. Continued support and hands on training

3. Rewarding work in a highly collaborative and congenial environment

4. Bonus eligibility


- M-W-F schedule

- Need to be able to have consistent schedule

- 20 hours a week is minimum hours that can be worked

- Cannot work less than 4 hours a day

- 20+ hours a week (able to determine how many hours you would like to work, and choose schedule)

See if you are a match!

See how well your resume matches up to this job - upload your resume now.

Find your dream job anywhere
with the LiveCareer app.
Download the
LiveCareer app and find
your dream job anywhere

Boost your job search productivity with our
free Chrome Extension!

lc_apply_tool GET EXTENSION

Similar Jobs

Want to see jobs matched to your resume? Upload One Now! Remove
Utilization Review Case Mgmt Nurse I


Posted 3 weeks ago

VIEW JOBS 10/28/2018 12:00:00 AM 2019-01-26T00:00 ESSENTIAL FUNCTIONS AND RESPONSIBILITIES: * Identifies the necessity of the review process and communicates any specific issues of concern to the appropriate claims staff/customer. * Collects data and analyzes information to make decisions regarding certification or denial of treatment. Documenting all work in the appropriate manner. * Requires regular and consistent attendance. * Complies with all safety rules and regulations during work hours in conjunction with the Injury and Illness Prevention Program (IIPP). * Additional duties as required. KNOWLEDGE & SKILLS: * Must have a thorough knowledge of both CPT and ICD coding. * Effective multi-tasking skills in a high-volume, fast-paced, team-oriented environment. * Ability to interface with claims staff, attorneys, physicians and their representatives, and advisors/clients and coworkers. * Ability to promote and market utilization review products with attorneys and claims staff. * Strong ability to negotiate provider fees effectively. * Excellent written and verbal communication skills. * Ability to meet designated deadlines * Computer proficiency and technical aptitude with the ability to utilize MS Office including Excel spreadsheets * Strong interpersonal, time management and organizational skills. * Ability to work both independently and within a team environment. EDUCATION/EXPERIENCE: * Graduate of accredited school of nursing with a diploma/Associates degree (Bachelor of Science degree or Bachelor of Science in Nursing preferred) * Current Nursing licensure in the state of operation required. * RN is required unless local state regulations permit LVN/LPN. * 4 or more years of recent clinical experience. * Previous experience in the following areas, preferred: * Prospective, concurrent and retrospective utilization review * Experience in the clinical areas of O.R., I.C.U., C.C.U., E.R., orthopedics * Knowledge of the workers' compensation claims process * Outpatient utilization review CorVel Corporation is an Equal Opportunity Employer. In order to provide equal employment and advancement opportunities to all individuals, employment decisions at CorVel will be based on merit, qualifications and abilities. Except where required or permitted by law, employment practices will not be influenced or affected by an applicant's or employee's race, color, religion, sex, national origin, ancestry, citizenship, age, handicap or disability, marital status, medical condition or any other characteristic protected by applicable law. Note to Employment Agencies: Please do not forward agency resumes. CorVel Corporation is not responsible for any fees related to unsolicited resumes. Please be aware that CorVel generally does not review all applications/resumes submitted in response to job openings posted on the Internet because of the large volume of responses Corvel Dallas TX

Remote Utilization Review- General Surgeon

Expired Job

Healthcare Recruiters