Physician Reviewer Internal Medicine-Field Medical Director, Radiology (Part Time)

Key Responsibilities

Serve as a physician reviewer for imaging cases to determine medical necessity and conduct peer-to-peer discussions with providers. Ensure compliance with URAC and NCQA guidelines while providing clinical rationale for appeals.

Requirements

Requires an MD/DO/MBBS degree with board certification and at least five years of post-residency medical practice. Must hold an unrestricted clinical license in the home state and have no history of federal or state sanctions.

Qualifications

Education

Doctoral or professional degree (postgraduate degree)

Experience

5+ years of experience

Certifications

Key Skills