Physician Reviewer - 6722344_1-7970 Job at ACS Solutions, Springfield, IL

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  • ACS Solutions
  • Springfield, IL

Job Description

This job was posted by : For more

information, please see: **W

e bring you tomorrow\'s opportunity, today.**

Volt is immediately hiring a Physician Reviewer in **Remote within

the 5 states of (Illinois, New Mexico, Texas, Montana, or Oklahoma)**!

As a Physician Reviewer, you will **:

Job Specifications; Typically has the following skills or abilities:**

  • Evaluates clinical service requests made by an organization\'s
members and providers.
  • Uses clinical judgment in conjunction with organization\'s criteria
to adjudicate these requests.
  • May also provide clinical leadership in other areas of the
organization.
  • Identifies opportunities to manage members\' clinical situations
with a view toward creative problem solving and anticipation of possible future clinical problems for the member.
  • Participates in the process to evaluate clinical service requests.
  • Practices anticipatory case management for members whose cases come
for review, in partnership with case managers.
  • Participates in the Physician Review Units\' appeal process of
service denials.
  • Participates in the development of Physician Review Units\' policies
and procedures.
  • Actively participates in all unit continuous quality improvement
activities.
  • Other duties as assigned by the Medical Director.
  • Board Certified (ABMS) M.D. or D.O, unrestricted and active license
to practice medicine requested and 5 years clinical experience to include inpatient experience, or any combination of education/experience that would provide an equivalent background.
  • Must understand managed care and demonstrate PC proficiency, as file
review will be done via computer in most cases.
  • (Note: Position does not provide direct patient care or medical
diagnosis.)

Preferred Qualification(s): New Mexico licensure would be desired

but not required.

This is a Full-Time opportunity

**.

Schedule: Monday-Friday,

Location: Remote within the 5 states of (Illinois, New Mexico, Texas,

Montana, or Oklahoma).

Duration: 24+ Months

Pay Range: \$110--\$120 per hour

Salary range: \$250000/yr**

*Pay range offered to a successful candidate will be based on several

factors, including the candidate\'s education, work experience, work location, specific job duties, certifications, etc.

Qualified candidates should APPLY NOW for immediate consideration!

Please hit APPLY to provide the required information, and we will be back in touch as soon as possible.

Benefits: Volt offers benefits (based on eligibility) that include

the following: health, dental, vision, term life, short term disability, AD&D, 401(k), Sick time, and other types of paid leaves (as required by law), Employee Assistance Program (EAP).

Volt is an Equal Opportunity Employer and prohibits any kind of

unlawful discrimination and harassment. Volt is committed to the principle of equal employment opportunity for all employees and to providing employees with a work environment free of discrimination and harassment on the basis of race, color, religion or belief, national origin, citizenship, social or ethnic origin, sex, age, physical or mental disability, veteran status, marital status, domestic partner status, sexual orientation, or any other status protected by the statutes, rules, and regulations in the locations where it operates. If you are an individual with a disability and need a reasonable accommodation to assist with your job search or application for employment, please email hr_dept@volt.com or call (866) -898-0005. Please indicate the specifics of the assistance needed.

Volt does not discriminate against applicants based on citizenship

status, immigration status, or national origin, in accordance with8 U.S.C. 1324b. The company will consider for employment qualified applicants with arrest and conviction records in a manner that complies with the San Francisco Fair Chance Ordinance, the Los Angeles Fair Chance Initiative for Hiring Ordinance, and other applicable laws.

By applying for this job, you agree to receive calls, AI-generated

calls, text messages, or emails from VOLT and its affiliates, and contracted partners. Frequency varies for text messages. Message and data rates may apply. Carriers are not liable for delayed or undelivered messages. You can reply STOP to cancel and HELP for help. You can access our privacy policy at volt-information-sciences-privacy-policy.pdf

Job Tags

Hourly pay, Full time, Temporary work, Work experience placement, Immediate start, Remote work, Monday to Friday,

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